1
|
Wang X, Zhou M, Wang X, Liu L, Zhang C. Effect of continuous renal replacement therapy on the clinical efficacy and pharmacokinetics of polymyxin B in the treatment of severe pulmonary infection. Heliyon 2024; 10:e27558. [PMID: 38509986 PMCID: PMC10951545 DOI: 10.1016/j.heliyon.2024.e27558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Objective This study aimed to evaluate the pharmacokinetics of polymyxin B in patients with ventilator-associated pneumonia caused by multi-drug resistant bacteria, and to analyze the effect of continuous renal replacement therapy (CRRT) on pharmacokinetics of polymyxin B. Methods Thirty-five patients with ventilator-associated pneumonia caused by multi-drug resistant bacteria admitted to our hospital from June 2021 to January 2022 were selected as the subjects. The patients were divided into the standard group (n = 20) and the non-standard group (n = 15) based on the factors affecting the compliance of polymyxin B plasma concentration. The patients received with polymyxin B and the plasma concentration was monitored. According to the monitoring results, they were divided into the standard group and the non-standard group, to analyze the influencing factors of polymyxin B on the blood concentration. Besides, the patients were then divided into the control group (n = 28) and the observation group (n = 7) according to whether the patients received CRRT treatment. Patients in the control group treated with polymyxin B alone, while patients in the observation group received with polymyxin B and CRRT. The general data of patients in the two groups were compared. The levels of plasma concentration of polymyxin B measured before the next administration (Cmin), peak plasma concentration of polymyxin B measured immediately after end of infusion (Cmax) and intermediate plasma concentration measured 6 h after administration (midpoint of the dosing interval) (C1/2t) were detected and compared between the two groups. Correlation between pharmacokinetics and efficacy was analyzed by Spearman correlation. The incidence of complications and the 28-day mortality rate of the two groups were recorded. Results The age, body mass index (BMI) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores in the non-standard group were higher than these in the standard group (p < 0.05). BMI and APACHE II scores were independent risk factors affecting the pharmacokinetics of polymyxin B in patients with severe pulmonary infection (p < 0.05). There were no significant differences in age, BMI, APACHEII score, alanine aminotransferase level, aspartate aminotransferase level, albumin level, gender and diabetes ratio between the control group and the observation group (p > 0.05). The levels of Cmin, Cmax, and C1/2t in the observation group were lower than these in the control group (p < 0.001). The response rate was 50.00% in the control group and 36.36% in the observation group (p > 0.05). The levels of Cmin, Cmax, and C1/2t in the observation group were no significant correlation with the clinical efficacy (p > 0.05), while these in the control group were positive correlation with the clinical efficacy (r = 0.485, p < 0.05). There was no significant difference in the incidence of skin pigmentation, nephrotoxicity and 28-day mortality between the two groups (p > 0.05). Conclusion In patients with ventilator-associated pneumonia not receiving multidrug-resistant bacteria, the rate of achieving blood drug concentration with the usual recommended dose of polymyxin B was satisfactory. However, the proportion of patients with a 6-h plasma concentration exceeding the maximum plasma concentration was high. BMI and APACHE II scores were important factors affecting the pharmacokinetics of polymyxin B. In patients undergoing CRRT, the plasma concentration of polymyxin B was significantly reduced, suggesting that in patients with severe disease, plasma concentration monitoring played an important role in drug efficacy and patient safety. In patients treated with CRRT, the dose of polymyxin B may need to be increased.
Collapse
Affiliation(s)
- Xi Wang
- Department of Intensive Care Medicine, The Third People's Hospital of Chengdu, Sichuan, PR China
| | - Mingming Zhou
- Department of Critical Care Medicine, Chongqing University Affiliated Cancer Hospital, Chongqing, PR China
| | - Xiyu Wang
- Department of Intensive Care Medicine, The Third People's Hospital of Chengdu, Sichuan, PR China
| | - Lian Liu
- Department of Intensive Care Medicine, The Third People's Hospital of Chengdu, Sichuan, PR China
| | - Chuan Zhang
- Department of Intensive Care Medicine, The Third People's Hospital of Chengdu, Sichuan, PR China
| |
Collapse
|
2
|
Wang W, Xia H, Dai B. Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones. World J Gastrointest Surg 2024; 16:759-767. [DOI: 10.4240/wjgs.v16.i3.759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Bile duct stones (BDSs) may cause patients to develop liver cirrhosis or even liver cancer. Currently, the success rate of surgical treatment for intrahepatic and extrahepatic BDSs is not satisfactory, and there is a risk of postoperative complications.
AIM To compare the clinical effects of dual-modality endoscopy (duodenoscopy and laparoscopy) with those of traditional laparotomy in the treatment of intra- and extrahepatic BDSs.
METHODS Ninety-five patients with intra- and extrahepatic BDSs who sought medical services at Wuhan No.1 Hospital between August 2019 and May 2023 were selected; 45 patients in the control group were treated by traditional laparotomy, and 50 patients in the research group were treated by dual-modality endoscopy. The following factors were collected for analysis: curative effects, safety (incision infection, biliary fistula, lung infection, hemobilia), surgical factors [surgery time, intraoperative blood loss (IBL) volume, gastrointestinal function recovery time, and length of hospital stay], serum inflammatory markers [tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-8], and oxidative stress [glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), and advanced protein oxidation products (AOPPs)].
RESULTS The analysis revealed markedly better efficacy (an obviously higher total effective rate) in the research group than in the control group. In addition, an evidently lower postoperative complication rate, shorter surgical duration, gastrointestinal function recovery time and hospital stay, and lower IBL volume were observed in the research group. Furthermore, the posttreatment serum inflammatory marker (TNF-α, IL-6, and IL-8) levels were significantly lower in the research group than in the control group. Compared with those in the control group, the posttreatment GSH-Px, SOD, MDA and AOPPs in the research group were equivalent to the pretreatment levels; for example, the GSH-Px and SOD levels were significantly higher, while the MDA and AOPP levels were lower.
CONCLUSION Dual-modality endoscopy therapy (duodenoscopy and laparoscopy) is more effective than traditional laparotomy in the treatment of intra- and extrahepatic BDSs and has a lower risk of postoperative complications; significantly shortened surgical time; shorter gastrointestinal function recovery time; shorter hospital stay; and lower intraoperative bleeding volume, while having a significant inhibitory effect on excessive serum inflammation and causing little postoperative oxidative stress.
Collapse
Affiliation(s)
- Wei Wang
- Department of Hepatobiliary Surgery, Wuhan No.1 Hospital, Wuhan 430030, Hubei Province, China
| | - Hui Xia
- Department of Hepatobiliary Surgery, Wuhan No.1 Hospital, Wuhan 430030, Hubei Province, China
| | - Bin Dai
- Department of Hepatobiliary Surgery, Wuhan No.1 Hospital, Wuhan 430030, Hubei Province, China
| |
Collapse
|
3
|
Pan J, Jia Y, Shi J, Yao R, Guo J. The efficacy and safety of compound kushen injection for adults with esophageal cancer: A meta-analysis of randomized controlled trials. J Ethnopharmacol 2024; 322:117604. [PMID: 38113988 DOI: 10.1016/j.jep.2023.117604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/03/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Compound Kushen injection (CKI), derived from the traditional Chinese medicine Sophora flavescens, has been widely prescribed to treat a variety of cancers including esophageal cancer (ESCA) in China. AIM OF THE STUDY This study aimed to evaluate the efficacy and safety of CKI for ESCA systematically. METHODS The protocol was registered in the PROSPERO database with No. CRD42022320503. PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang Database, Clinicaltrials, and Chi-CTR were searched to select RCTs that compared CKI with other interventions for ESCA with outcome measures including clinical efficacy, complete response, quality of life (QoL), adverse events (AEs), and serious AEs (SAEs). The Cochrane Risk of Bias 2 (RoB2) tool was used to assess the quality of RCT. The overall effect sizes were estimated with odds ratios (ORs) and 95% confidence intervals (CIs) on binary outcome data. Meta-analyses were conducted to estimate effect sizes. Subgroup and sensitivity analyses on characteristics of RCTs were performed to test the robustness. Publication bias was also detected with different methods. The evidence strength was assessed with the Grading of Recommendation, Assessment, Development, and Evaluation method. RESULTS This study finally included 35 RCTs with 2491 ESCA patients. The RoB of RCTs was some concern. The effect size of OR was 2.92 (95% CI [2.39, 3.57]) on clinical efficacy, 2.27 (95% CI [1.84, 2.81]) on complete response, 3.71 (95% CI [2.86, 4.80]) on QoL, 0.39 (95% CI [0.30, 0.50]) on AEs, and 0.13 (95% CI [0.07, 0.27]) on SAEs where the statistical significances (P < 0.00001) were found for all outcome measures. These overall effect sizes showed that CKI was more efficacious and safety for ESCA. Moreover, subgroup and sensitivity analyses found consistent results. Most publication bias analyses showed insignificant differences. The evidence strengths were moderate. CONCLUSION The moderate evidence from this comprehensive PRISMA-compliant meta-analysis suggested that CKI may be a valuable alternative for adult patients with ESCA on its significant efficacy and safety. However, more RCTs of high quality with low RoB, large sample sizes, and long follow-up periods are still warranted to update the ESCA clinical guideline for physicians and policymakers in further study.
Collapse
Affiliation(s)
- Jiangpeng Pan
- The Research and Application Center of Precision Medicine, The Second Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, PR China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Yongliang Jia
- BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Jianxiang Shi
- BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Ruinan Yao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Jiancheng Guo
- The Research and Application Center of Precision Medicine, The Second Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, PR China.
| |
Collapse
|
4
|
Liu K, Li M, Li Y, Li Y, Chen Z, Tang Y, Yang M, Deng G, Liu H. A review of the clinical efficacy of FDA-approved antibody‒drug conjugates in human cancers. Mol Cancer 2024; 23:62. [PMID: 38519953 PMCID: PMC10960395 DOI: 10.1186/s12943-024-01963-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/21/2024] [Indexed: 03/25/2024] Open
Abstract
While strategies such as chemotherapy and immunotherapy have become the first-line standard therapies for patients with advanced or metastatic cancer, acquired resistance is still inevitable in most cases. The introduction of antibody‒drug conjugates (ADCs) provides a novel alternative. ADCs are a new class of anticancer drugs comprising the coupling of antitumor mAbs with cytotoxic drugs. Compared with chemotherapeutic drugs, ADCs have the advantages of good tolerance, accurate target recognition, and small effects on noncancerous cells. ADCs occupy an increasingly important position in the therapeutic field. Currently, there are 13 Food and Drug Administration (FDA)‒approved ADCs and more than 100 ADC drugs at different stages of clinical trials. This review briefly describes the efficacy and safety of FDA-approved ADCs, and discusses the related problems and challenges to provide a reference for clinical work.
Collapse
Affiliation(s)
- Kaifeng Liu
- Laboratory of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Meijia Li
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Yudong Li
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Yutong Li
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Zixin Chen
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Yiqi Tang
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Meitian Yang
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Guoquan Deng
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China
| | - Hongwei Liu
- Laboratory of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
- The First Clinical College, Guangdong Medical University, Zhanjiang, 524023, China.
| |
Collapse
|
5
|
Tang L, Chen Y, Wang F, Liu Y, Song Z, Wang M, Zhou Y, Liu H, Zheng J. Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis. BMC Musculoskelet Disord 2024; 25:223. [PMID: 38504222 PMCID: PMC10953196 DOI: 10.1186/s12891-024-07356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE Our study aimed to develop a day anterior cervical discectomy and fusion (ACDF) procedure to treat degenerative cervical spondylosis (DCS). The goal was to analyze its clinical implications, safety, and early effects to provide a better surgical option for eligible DCS patients. METHODS A retrospective analysis was performed to identify DCS patients who underwent day ACDF from September 2022 to August 2023. The operative time, intraoperative blood loss, postoperative drainage, preoperative and postoperative visual analog scale (VAS) scores, neck disability index (NDI) scores, Japanese Orthopedic Association (JOA) scores, JOA recovery rate (RR), incidence of dysphagia-related symptoms, 30-day hospital readmission rate, and incidence of other complications were recorded to evaluate early clinical outcomes. Radiography was performed to assess the location of the implants, neurological decompression, and cervical physiological curvature. RESULTS All 33 patients (23 women and 10 men) underwent successful surgery and experienced significant symptomatic and neurological improvements. Among them, 26 patients underwent one-segment ACDF, 5 underwent two-segment ACDF, and 2 underwent three-segment ACDF. The average operative time was 71.1 ± 20.2 min, intraoperative blood loss was 19.1 ± 6.2 mL, and postoperative drainage was 9.6 ± 5.8 mL. The preoperative VAS and NDI scores improved postoperatively (7.1 ± 1.2 vs. 3.1 ± 1.3 and 66.7% ± 4.8% vs. 24.1% ± 2.5%, respectively), with a significant difference (P < 0.01). Moreover, the preoperative JOA scores improved significantly postoperatively (7.7 ± 1.3 vs. 14.2 ± 1.4; P < 0.01) with an RR of 93.9% in good or excellent. Postoperative dysphagia-related symptoms occurred in one patient (3.0%). During the follow-up period, no patient was readmitted within 30 days after discharge; however, an incisional hematoma was reported in one patient on the 6th day after discharge, which was cured by pressure dressing. The postoperative radiographs revealed perfect implant positions and sufficient nerve decompression in all patients. Furthermore, the preoperative cervical physiological curvature improved significantly after the operation (14.5° ± 4.0° vs. 26.3° ± 5.4°; P < 0.01). CONCLUSIONS Day ACDF has good safety and early clinical efficacy, and it could be an appropriate choice for eligible DCS patients.
Collapse
Affiliation(s)
- Long Tang
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
- Department of Neurosurgery, Klinikum Rechts Der Isar, Technical University of Munich, Ismaninger Straße 22, Munich, 81675, Germany
| | - Yu Chen
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
| | - Fandong Wang
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
| | - Yuanbin Liu
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
| | - Zhaojun Song
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
| | - Miao Wang
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
| | - Yong Zhou
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
| | - Huiyi Liu
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China
| | - Jiazhuang Zheng
- Department of Spine Surgery, Suining Central Hospital, 127 Desheng West Road, Suining, Sichuan Province, 629000, China.
| |
Collapse
|
6
|
Sun C, Xiang H, Wu X, Chen B, Guo Z. The influence of anterior cervical discectomy and fusion surgery on cervical muscles and the correlation between related muscle changes and surgical efficacy. J Orthop Surg Res 2024; 19:187. [PMID: 38493285 PMCID: PMC10943845 DOI: 10.1186/s13018-024-04605-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/31/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Anterior cervical discectomy and fusion surgery (ACDF) is a common technique in treating degenerative cervical spondylosis. This study is to evaluate the changes of cervical muscles after ACDF and analyze the correlation between related muscle changes and clinical efficacy. METHODS Sixty-five postoperative patients (single-level ACDF) with cervical spondylotic myelopathy from January 2013 to December 2022 were analyzed. The measured parameters include: the axial section of longus colli cross-sectional area (AxCSA), the volume of cervical longus, the ratio of long and short diameter line (RLS), the cervical extensor cross-sectional area (CESA), the vertebral body area (VBA), and the CESA/VBA. The visual analog scale (VAS), modified Japanese Orthopedic Association score (mJOA), and neck disability index (NDI) were evaluated. The changes in muscle morphology were analyzed, and the correlation analysis was conducted between morphological changes and function scores. RESULTS The postoperative AxCSA of surgical segment (3rd month, 12th month, and the last follow-up) was decreased compared to preoperative (141.62 ± 19.78), and the differences were significant (P < 0.05). The corresponding data reduced to (119.42 ± 20.08) mm2, (117.59 ± 19.69) mm2, and (117.41 ± 19.19) mm2, respectively (P < 0.05). The RLS increased, and the volume of cervical longus decreased significantly after surgery (P < 0.05). Negative correlation was found between postoperative volume of cervical longus and VAS at the 3rd month (r = - 0.412), 12th month (r = - 0.272), and last follow-up (r = - 0.391) (P < 0.05). Negative correlation existed between postoperative volume of cervical longus and NDI at the 3rd month (r = - 0.552), 12th month (r = - 0.293), and last follow-up (r = - 0.459) (P < 0.05). CONCLUSION The volume of cervical longus decreased and its morphology changed after ACDF surgery. The mainly affected muscle was the cervical longus closing to the surgical segment. Negative correlation was found between the postoperative volume of cervical longus and function scores (VAS and NDI).
Collapse
Affiliation(s)
- Chong Sun
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hongfei Xiang
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaolin Wu
- Department of Trauma Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Bohua Chen
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
| | - Zhu Guo
- Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
| |
Collapse
|
7
|
Yan C, Yang T, Sun Y, Hu J, Yi X, Li C, Chen J, Wei K, Jiang J, Xiang Q, Liu A, Han Y, Yang L, Liu X, Han T, Liu X. Efficacy and safety of Perampanel in the treatment of post stroke epilepsy: A multicenter, real-world study. Heliyon 2024; 10:e26376. [PMID: 38434369 PMCID: PMC10907510 DOI: 10.1016/j.heliyon.2024.e26376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024] Open
Abstract
Background Since 2019, Perampanel (PER) has been endorsed in China as an adjunctive treatment for focal seizures, both with and without impaired awareness, and for the transition from focal to bilateral tonic-clonic seizures. Limited research exists regarding the efficacy of PER in treating post-stroke epilepsy (PSE) in China. Empirical studies are essential to guide treatment protocols. We conducted a retrospective study to assess the efficacy and tolerability of PER in 58 PSE patients treated between October 2019 and July 2023. Method This study encompassed 58 patients with PSE, treated with PER either as monotherapy or as part of adjunctive therapy, and underwent follow-up for a minimum duration of 6 months. The study assessed changes in seizure frequency, adverse events (AEs), drug retention rate, maintenance dose, and adverse reactions following PER treatment. Results The study included 58 PSE patients, with 60.3% males and 39.7% females, ranging in age from 18 to 89, mostly within the 61-70 age group. Ischemic strokes constituted 58.6% of cases, while hemorrhagic strokes accounted for 41.4%. Focal seizures, either with or without impaired awareness, were noted in 62.1% of patients, and a transition from focal to bilateral tonic-clonic seizures was seen in 32.8%. The retention rates for PER at 3 and 6 months stood at 94.8% and 84.5% respectively, and the most commonly administered maintenance dose was 4 mg/day (41.28%). In the adjunctive therapy group, efficacy rates were 66.7% at 3 months and 78.6% at 6 months, compared to 80.0% at 3 months and 85.7% at 6 months in the monotherapy group. In the efficacy analysis, with a criterion of ≥50% reduction in seizure frequency, the overall efficacy rates at 3 and 6 months were 69.1% and 79.6%, respectively. Adverse reactions occurred in 46.6% of patients, primarily involving irritability and somnolence (both 27.6%), with no marked difference in incidence between the adjunctive and monotherapy groups (P > 0.05). Conclusion PER exhibits favorable efficacy and tolerability in Chinese PSE patients, possibly at lower doses.
Collapse
Affiliation(s)
- Cuihua Yan
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, PR China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
- Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
| | - Tingting Yang
- Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong, PR China
| | - Yuanping Sun
- Qingdao University Affiliated Hospital, Qingdao, Shandong, PR China
| | - Junji Hu
- Department of Neurology, Zibo Changguo Hospital, Zibo, Shandong, PR China
| | - Xiangming Yi
- Binzhou Medical College Affiliated Hospital, Binzhou, Shandong, PR China
| | - Chunxiao Li
- Qingdao University Affiliated Hospital, Qingdao, Shandong, PR China
| | - Juan Chen
- The Third People's Hospital of Heze City, Heze, Shandong, PR China
| | - Kunkun Wei
- Qingdao Women and Children's Hospital, Qingdao, Shandong, PR China
| | - Jing Jiang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
- Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
| | - Qi Xiang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
- Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
| | - Anru Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
- Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
| | - Yuxiang Han
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
| | - Liling Yang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
| | - Xiaoyun Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
| | - Tao Han
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
- Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, PR China
| | - Xuewu Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
- Institute of Epilepsy, Shandong University, Jinan, Shandong, PR China
| |
Collapse
|
8
|
Miao L, Jin B, Ning M, Zhang X, Wang Z, Mai R, Cai L, Wang Y. The Effect of Unintended Facet Arthrodesis on the Treatment Outcome of Dynamic Neutralization System for Lumbar Degenerative Diseases. Indian J Orthop 2024; 58:271-277. [PMID: 38425823 PMCID: PMC10899546 DOI: 10.1007/s43465-023-01088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024]
Abstract
Purpose This study aimed to examine the influence of unintended facet arthrodesis on the therapeutic effectiveness of the dynamic neutralization system (Dynesys). Methods This retrospective study enrolled consecutive patients who underwent posterior decompression and dynamic stabilization for lumbar spondylosis or spinal stenosis. Follow-up assessments included lumbar radiography, lumbar vertebral computerized tomography (CT), visual analog scale (VAS), and Oswestry disability index (ODI). Patients were classified into the facet fusion and non-fusion groups. The differences in the VAS scores for back pain and leg pain, ODI, intervertebral range of motion (ROM) at the surgical segments, and upper adjacent segments were assessed before and after treatment. Results A total of 49 patients (29 males and 20 females) aged 31-65 years were enrolled and followed-up for over 40 months. Among the patients, 16 (32.7%) experienced unintended facet arthrodesis and were assigned to the fusion group, whereas the remaining patients were assigned to the non-fusion group. There was a significant increase in the incidence of facet arthrodesis in the surgical segments over time post-surgery (χ2 = 6.2, p < 0.05). The ROM of the surgical and upper adjacent segments, VAS scores for back pain and leg pain, and ODI were all significantly different before and after the operation (p < 0.05), but not between the fusion and non-fusion groups (p > 0.05). Conclusion Although unintended facet arthrodesis is common after Dynesys procedure, the presence of facet arthrodesis does not significantly affect the efficacy of Dynesys in treating lumbar degenerative diseases.
Collapse
Affiliation(s)
- Lei Miao
- Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002 Ningxia China
| | - Bo Jin
- Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002 Ningxia China
| | - Ma Ning
- Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002 Ningxia China
| | - Xi Zhang
- Department of Pharmacy, General Hospital of Ningxia Medical University, Yinchuan, 750004 Ningxia China
| | - Zhaowei Wang
- Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002 Ningxia China
- The Third School of Clinical Medicine, Ningxia Medical University, Ningxia, China
| | - Ruopeng Mai
- Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002 Ningxia China
| | - Lijun Cai
- Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002 Ningxia China
| | - Yinong Wang
- Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002 Ningxia China
| |
Collapse
|
9
|
Wang RL, Lin FF, Ruan DD, Li SJ, Zhou YF, Luo JW, Fang ZT, Tang Y. A correlation study between prostate necrosis rate calculated by 3D Slicer software and clinical efficacy of prostatic artery embolization, along with an analysis of predictors of clinical success after prostatic artery embolization. Abdom Radiol (NY) 2024; 49:927-938. [PMID: 38158423 DOI: 10.1007/s00261-023-04131-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To analyze the correlation between the prostate necrosis rate at 1-month after prostatic artery embolization (PAE) and the clinical efficacy at 1-year after PAE, and to explore potential predictors of clinical success after PAE for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH). METHODS The prostate magnetic resonance imaging data at 1-month after PAE were imported into 3D Slicer software for calculating the prostate necrosis rate and thus analyzing the relationship between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after PAE. The 151 patients with PAE technical success were divided into a clinical success group (n = 126) and a clinical failure group (n = 25). Independent predictors of clinical success after PAE were analyzed by multifactorial logistic regression, and the predictive performance of each factor was evaluated by applying the receiver operating characteristic curve and the area under the curve (AUC). RESULTS There was a linear negative correlation between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after surgery (P < 0.001). In the clinical success group, both the initial prostate volume (PV) and the prostate necrosis rate at 1-month after PAE were significantly higher than in the clinical failure group (P < 0.001), and acute urinary retention (AUR) and adenomatous-dominant BPH were also associated with clinical success (P < 0.05). Multifactorial logistic regression analysis revealed that larger initial PV, a higher prostate necrosis rate at 1-month after surgery, and AUR were independent predictors of clinical success after PAE. The AUC values for these three indicators and their combination were 0.720, 0.928, 0.599, and 0.951, respectively, in which the prostate necrosis rate at 1-month after PAE demonstrating a high predictive value. CONCLUSION The higher the prostate necrosis rate at 1-month after PAE, the better the clinical efficacy at 1-year after PAE is likely to be, and the prostate necrosis rate at 1-month after PAE is expected to become a predictor of clinical success after PAE.
Collapse
Affiliation(s)
- Ruo-Li Wang
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou, 350001, China
| | - Fang-Fang Lin
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Radiology Department, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Dan-Dan Ruan
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
| | - Shi-Jie Li
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
| | - Yan-Feng Zhou
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Jie-Wei Luo
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
| | - Zhu-Ting Fang
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, 350001, China.
| | - Yi Tang
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, 350001, China.
| |
Collapse
|
10
|
Jing Y, Shu R, Wu T, Liu D, Luo X, Sun J, Chen F. Clinical efficacy of photodynamic therapy of oral potentially malignant disorder. Photodiagnosis Photodyn Ther 2024; 46:104026. [PMID: 38403144 DOI: 10.1016/j.pdpdt.2024.104026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/05/2024] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To investigate the clinical efficacy of aminovalerate hydrochloride photodynamic therapy (PDT) for oral potentially malignant disorder (OPMD),oral leukoplakia (OLK), along with identifying the influencing factors.Additionally, the study aims to detect the rates of recurrence and malignancy after PDT. METHOD 60 patients with OPMD who received PDT at our hospital from 2006 to 2021 were included in this study. Relevant patient medical data were collected and analyzed using SAS 9.4 software.The Mann-Whitney U test was used to retrospectively analyze the factors influencing clinical efficacy, as well as recurrence rate and malignant transformation rate (MTR) after treatment. RESULT Among the 60 OPMD patients receiving PDT, complete remission in 13 (21.67 %), partial remission in 39 (65.00 %), and no remission in eight (13.33 %), resulting in an overall effective rate of 86.67 %.Fifteen patients experienced relapse, leading to a recurrence rate of 25.00 %. Among these relapses,11 patients occurred within one year after treatment, corresponding to an 18.33 % recurrence rate during that period. Moreover, nine patients developed malignant transformation (MT), resulting in an MTR of 15.00 %. Out of these patients, six individuals developed MT within one year after treatment, resulting in a one-year MTR of 10.00 %. CONCLUSION The study findings indicate that PDT shows promising clinical efficacy in the treatment of OPMD, with relatively limited and tolerable postoperative adverse reactions. However, there remains a certain rate of recurrence and malignancy after treatment. Therefore, close attention should be paid to postoperative monitoring, regular follow-up, and further expansion of the sample size to observe its long-term efficacy.
Collapse
Affiliation(s)
- Yin Jing
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering, Chongqing 401147, China
| | - Rong Shu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Tingting Wu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Dongqi Liu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Xiao Luo
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Jun Sun
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Fangchun Chen
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China.
| |
Collapse
|
11
|
Pan D, Liu HN, Qu PF, Ma X, Ma LY, Chen XX, Wang YQ, Qin XB, Han ZX. Progress in the treatment of advanced hepatocellular carcinoma with immune combination therapy. World J Gastrointest Oncol 2024; 16:273-286. [PMID: 38425407 PMCID: PMC10900147 DOI: 10.4251/wjgo.v16.i2.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/13/2023] [Accepted: 01/08/2024] [Indexed: 02/02/2024] Open
Abstract
Advanced hepatocellular carcinoma (HCC) is a severe malignancy that poses a serious threat to human health. Owing to challenges in early diagnosis, most patients lose the opportunity for radical treatment when diagnosed. Nonetheless, recent advancements in cancer immunotherapy provide new directions for the treatment of HCC. For instance, monoclonal antibodies against immune checkpoint inhibitors (ICIs) such as programmed cell death protein 1/death ligand-1 inhibitors and cytotoxic t-lymphocyte associated antigen-4 significantly improved the prognosis of patients with HCC. However, tumor cells can evade the immune system through various mechanisms. With the rapid development of genetic engineering and molecular biology, various new immunotherapies have been used to treat HCC, including ICIs, chimeric antigen receptor T cells, engineered cytokines, and certain cancer vaccines. This review summarizes the current status, research progress, and future directions of different immunotherapy strategies in the treatment of HCC.
Collapse
Affiliation(s)
- Di Pan
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Hao-Nan Liu
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Peng-Fei Qu
- Department of Gastroenterology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Xiao Ma
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Lu-Yao Ma
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Xiao-Xiao Chen
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Yu-Qin Wang
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Xiao-Bing Qin
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Zheng-Xiang Han
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| |
Collapse
|
12
|
Sharma Y, Cheung L, Patterson KK, Iaboni A. Factors influencing the clinical adoption of quantitative gait analysis technology with a focus on clinical efficacy and clinician perspectives: A scoping review. Gait Posture 2024; 108:228-242. [PMID: 38134709 DOI: 10.1016/j.gaitpost.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/14/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Quantitative gait analysis (QGA) has the potential to support clinician decision-making. However, it is not yet widely accepted in practice. Evidence for clinical efficacy (i.e., efficacy and effectiveness), as well as a users' perspective on using the technology in clinical practice (e.g., ease of use and usefulness) can help impact their widespread adoption. OBJECTIVE To synthesize the literature on the clinical efficacy and clinician perspectives on the use of gait analysis technologies in the clinical care of adult populations. METHODS This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. We included peer-reviewed and gray literature (i.e., conference abstracts). A search was conducted in MEDLINE (Ovid), CENTRAL (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and SPORTDiscus (EBSCO). Included full-text studies were critically appraised using the JBI critical appraisal tools. RESULTS A total of 15 full-text studies and two conference abstracts were included in this review. Results suggest that QGA technologies can influence decision-making with some evidence to suggest their role in improving patient outcomes. The main barrier to ease of use was a clinician's lack of data expertise, and main facilitator was receiving support from staff. Barriers to usefulness included challenges finding suitable reference data and data accuracy, while facilitators were enhancing patient care and supporting clinical decision-making. SIGNIFICANCE This review is the first step to understanding how QGA technologies can optimize clinical practice. Many gaps in the literature exist and reveal opportunities to improve the clinical adoption of gait analysis technologies. Further research is needed in two main areas: 1) examining the clinical efficacy of gait analysis technologies and 2) gathering clinician perspectives using a theoretical model like the Technology Acceptance Model to guide study design. Results will inform research aimed at evaluating, developing, or implementing these technologies. FUNDING This work was supported by the Walter and Maria Schroeder Institute for Brain Innovation and Recovery and AGE-WELL Graduate Student Award in Technology and Aging [2021,2022].
Collapse
Affiliation(s)
- Yashoda Sharma
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada
| | - Lovisa Cheung
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada
| | - Kara K Patterson
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada
| | - Andrea Iaboni
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, 550 University Avenue, M5G 2A2 Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, M5T 1R8 Toronto, ON, Canada.
| |
Collapse
|
13
|
Tan L, Du X, Tang R, Rong L, Zhang L. Preoperative Adjacent Facet Joint Osteoarthritis Is Associated with the Incidence of Adjacent Segment Degeneration and Low Back Pain after Lumbar Interbody Fusion. Asian Spine J 2024; 18:21-31. [PMID: 38379146 PMCID: PMC10910148 DOI: 10.31616/asj.2023.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 02/22/2024] Open
Abstract
STUDY DESIGN A retrospective cohort study. PURPOSE To analyze the association between preoperative adjacent facet joint osteoarthritis (FJOA) and outcomes of lumbar interbody fusion (LIF). OVERVIEW OF LITERATURE Whether preoperative adjacent FJOA is associated with the incidence of radiological adjacent segment degeneration (RASD) and low back pain (LBP) relief after lumbar fusion remains unknown. METHODS The study included patients who underwent LIF. The demographic characteristics and radiographic and surgical data were collected and evaluated. The included patients were divided into control group and FJOA group based on the preoperative adjacent facet joint Pathria grade. Preoperative and last follow-up LBP Visual Analog Scale (VAS) score, leg pain (LP) VAS, Oswestry Disability Index (ODI) and RASD were evaluated and compared. The improvement rates in VAS and ODI were calculated and compared between the two groups. Logistic regression was used to analyze the risk factors of LBP relief and incidence of RASD. RESULTS In total, 197 patients (control group, 86; FJOA group, 111) were included, and the median follow-up was 46 months. The VAS and ODI in both groups significantly improved after surgery. At the last follow-up, the FJOA group had higher VAS and lower VAS improvement rates of LBP than the control group (p<0.05). However, no significant difference in the LP VAS and ODI was found between the two groups. The incidence of RASD in the FJOA group was significantly higher than that in the control group (48.6% vs. 30.2%, p=0.034). Multivariate logistic regression analysis showed that preoperative adjacent FJOA was significantly associated with LBP relief (odds ratio [OR], 0.691; 95% confidence interval [CI], 0.498-0.958) and the postoperative incidence of RASD (OR, 1.406; 95% CI, 1.020-1.939). CONCLUSIONS The preoperative FJOA in the adjacent segments was significantly associated with LBP following LIF. Patients with preoperative FJOA were more likely to have RASD following lumbar fusion surgery.
Collapse
Affiliation(s)
- Lixian Tan
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou,
China
| | - Xiaokang Du
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou,
China
| | - Runmin Tang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou,
China
| | - Limin Rong
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou,
China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou,
China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou,
China
| | - Liangming Zhang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou,
China
- Guangdong Provincial Center for Quality Control of Minimally Invasive Spine Surgery, Guangzhou,
China
- Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou,
China
| |
Collapse
|
14
|
Shao J, Hu M, Wang W, Pan Z, Zhao D, Liu J, Lv M, Zhang Y, Li Z. Indocyanine green based photodynamic therapy for keloids: Fundamental investigation and clinical improvement. Photodiagnosis Photodyn Ther 2024; 45:103903. [PMID: 37989473 DOI: 10.1016/j.pdpdt.2023.103903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/05/2023] [Accepted: 11/17/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Keloid, a prevalent pathological skin lesion, presents significant challenges in terms of treatment efficacy. Photodynamic therapy (PDT), an increasingly popular adjuvant treatment, has shown significant potential in the management of various disorders, including cancer. However, the therapeutic potential of indocyanine green-mediated photodynamic therapy (ICG-PDT) for keloids has not yet been demonstrated. METHODS In this study, we divided the experimental groups into control group, Photothermal Therapy group, Photodynamic Therapy group, and Combined Therapy group. The in vitro investigation aimed to optimize the clinical application of PDT for keloid treatment by elucidating its underlying mechanism. Subsequently, on this basis, we endeavored to manage a clinical case of keloid by employing surgical intervention in conjunction with modified ICG-PDT. RESULTS Our investigation revealed an unexpected outcome that ICG-PDT maximally inhibited the cellular activity and migration of keloid fibroblasts only when photodynamic mechanism took effect. Additionally, the induction of autophagy and apoptosis, as well as the inhibition of collagen synthesis, were particularly evident in this experimental group. Furthermore, the above therapeutic effect could be achieved at remarkably low drug concentrations. Building upon the aforementioned experimental findings, we successfully optimized the treatment modality for the latest case and obtained a more favorable treatment outcome. CONCLUSIONS This study investigated the mechanism of ICG-PDT treatment and optimized the in vivo treatment regimen, demonstrating the significant therapeutic potential of ICG-PDT treatment in clinical keloid treatment.
Collapse
Affiliation(s)
- Junyi Shao
- Department of Dermatology and Venereology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Murong Hu
- Department of Dermatology and Venereology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, 310000, China
| | - Wenwen Wang
- Department of Dermatology and Venereology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Zhaoqi Pan
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University,Wenzhou, Zhejiang, 325000, China
| | - Dewei Zhao
- Department of Urology, Wenzhou Central Hospital, Wenzhou, Zhejiang, 325000, China
| | - Jingjing Liu
- Department of Dermatology and Venereology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Mingfen Lv
- Department of Dermatology and Venereology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Yi Zhang
- Department of Dermatology and Venereology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
| | - Zhiming Li
- Department of Dermatology and Venereology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
| |
Collapse
|
15
|
Sun C, Wu X, Zhang X, Li S, Jia R, Sun D. Clinical efficacy of beraprost sodium in treating chronic kidney disease: A six-month prospective study. Heliyon 2024; 10:e24156. [PMID: 38293352 PMCID: PMC10825420 DOI: 10.1016/j.heliyon.2024.e24156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/19/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Objective To investigate the clinical efficacy of beraprost sodium (BPS) in the treatment of chronic kidney disease (CKD). Methods In this single-centre, prospective, controlled, single-blind study, 252 patients diagnosed with CKD and treated at the Affiliated Hospital of Xuzhou Medical University were enrolled from September 2018 to June 2021. All participants were randomised into three groups: the control, BPS 40 μg, and BPS 20 μg groups. Both treatment groups were administered conventional therapy for 6 months. Renal function in the three groups was measured and compared 3 and 6 months post-treatment. Results 1. Renal function in the BPS 20 μg and BPS 40 μg groups was better than that in the control group after 3 and 6 months of treatment. 2. After 3 months of treatment, the levels of serum creatinine (P = 0.043), cystatin C (P = 0.039), and 24 h urinary total protein (P = 0.041) in the BPS 40 μg group were significantly lower than those in the BPS 20 μg group, the eGFR (P = 0.046) level was higher than that in the BPS 20 μg group, and the index improvement rate was better than that in the BPS 20 μg group (P < 0.05). 3. After 6 months of treatment, the improvement in renal function in the BPS 20 μg group was close to that in the BPS 40 μg group (P > 0.05). Conclusion BPS improved renal function, reduced urinary protein levels, and delayed CKD progression. The clinical efficacy of BPS in the 40 μg group was faster than that in the BPS 20 μg group. The long-term use of BPS is effective in patients with CKD.
Collapse
Affiliation(s)
- Chen Sun
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
- Department of Nephrology, Xuzhou Central Hospital, Xuzhou, 221009, China
| | - Xin Wu
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
| | - Xin Zhang
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
| | - Shulin Li
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
- Institute of Nephrology, Xuzhou Medical University, Xuzhou, 221002, China
| | - Ruoyu Jia
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
| | - Dong Sun
- Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, China
- Institute of Nephrology, Xuzhou Medical University, Xuzhou, 221002, China
| |
Collapse
|
16
|
Otsuka K, Isobe J, Asai Y, Nakano T, Hattori K, Ariyoshi T, Yamashita T, Motegi K, Saito A, Kohmoto M, Hosonuma M, Kuramasu A, Baba Y, Murayama M, Narikawa Y, Toyoda H, Funayama E, Tajima K, Shida M, Hirasawa Y, Tsurui T, Ariizumi H, Ishiguro T, Suzuki R, Ohkuma R, Kubota Y, Sambe T, Tsuji M, Wada S, Kiuchi Y, Kobayashi S, Horiike A, Goto S, Murakami M, Kim YG, Tsunoda T, Yoshimura K. Butyricimonas is a key gut microbiome component for predicting postoperative recurrence of esophageal cancer. Cancer Immunol Immunother 2024; 73:23. [PMID: 38280026 PMCID: PMC10821974 DOI: 10.1007/s00262-023-03608-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/20/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Recently, intestinal bacteria have attracted attention as factors affecting the prognosis of patients with cancer. However, the intestinal microbiome is composed of several hundred types of bacteria, necessitating the development of an analytical method that can allow the use of this information as a highly accurate biomarker. In this study, we investigated whether the preoperative intestinal bacterial profile in patients with esophageal cancer who underwent surgery after preoperative chemotherapy could be used as a biomarker of postoperative recurrence of esophageal cancer. METHODS We determined the gut microbiome of the patients using 16S rRNA metagenome sequencing, followed by statistical analysis. Simultaneously, we performed a machine learning analysis using a random forest model with hyperparameter tuning and compared the data obtained. RESULTS Statistical and machine learning analyses revealed two common bacterial genera, Butyricimonas and Actinomyces, which were abundant in cases with recurrent esophageal cancer. Butyricimonas primarily produces butyrate, whereas Actinomyces are oral bacteria whose function in the gut is unknown. CONCLUSION Our results indicate that Butyricimonas spp. may be a biomarker of postoperative recurrence of esophageal cancer. Although the extent of the involvement of these bacteria in immune regulation remains unknown, future research should investigate their presence in other pathological conditions. Such research could potentially lead to a better understanding of the immunological impact of these bacteria on patients with cancer and their application as biomarkers.
Collapse
Affiliation(s)
- Koji Otsuka
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Junya Isobe
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
| | - Yoshiyuki Asai
- Department of Systems Bioinformatics, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
- AI Systems Medicine Research and Training Center, Graduate School of Medicine, Yamaguchi University and Yamaguchi University Hospital, Yamaguchi, Japan
| | - Tomohisa Nakano
- Department of Systems Bioinformatics, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kouya Hattori
- Research Center for Drug Discovery and Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
- Division of Biochemistry, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Tomotake Ariyoshi
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Takeshi Yamashita
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Kentaro Motegi
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Akira Saito
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Masahiro Kohmoto
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Masahiro Hosonuma
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
- Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan
- Pharmacological Research Center, Showa University, Tokyo, Japan
| | - Atsuo Kuramasu
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Yuta Baba
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Masakazu Murayama
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
- Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan
- Pharmacological Research Center, Showa University, Tokyo, Japan
- Department of Otorhinolaryngology-Head and Neck Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yoichiro Narikawa
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
- Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan
- Pharmacological Research Center, Showa University, Tokyo, Japan
- Department of Otorhinolaryngology-Head and Neck Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Hitoshi Toyoda
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
- Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan
- Pharmacological Research Center, Showa University, Tokyo, Japan
- Department of Orthopedic Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Eiji Funayama
- Division of Pharmacology, Department of Pharmacology, School of Pharmacy, Showa University, Tokyo, Japan
| | - Kohei Tajima
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Tokyo, Japan
| | - Midori Shida
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Yuya Hirasawa
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Toshiaki Tsurui
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ariizumi
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomoyuki Ishiguro
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Risako Suzuki
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Ryotaro Ohkuma
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yutaro Kubota
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takehiko Sambe
- Division of Clinical Pharmacology, Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan
| | - Mayumi Tsuji
- Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan
- Pharmacological Research Center, Showa University, Tokyo, Japan
| | - Satoshi Wada
- Department of Clinical Diagnostic Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Yuji Kiuchi
- Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan
- Pharmacological Research Center, Showa University, Tokyo, Japan
| | - Shinichi Kobayashi
- Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Atsushi Horiike
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Satoru Goto
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Masahiko Murakami
- Showa University Hospital Esophageal Cancer Center, Esophageal Surgery, Tokyo, Japan
| | - Yun-Gi Kim
- Research Center for Drug Discovery and Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Takuya Tsunoda
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kiyoshi Yoshimura
- Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
- Department of Clinical Immuno Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan.
- Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan.
- Pharmacological Research Center, Showa University, Tokyo, Japan.
| |
Collapse
|
17
|
Pu D, Xu D, Wu Y, Chen H, Shi G, Feng D, Zhang M, Liu Z, Li J. Efficacy of CDK4/6 inhibitors combined with endocrine therapy in HR+/HER2- breast cancer: an umbrella review. J Cancer Res Clin Oncol 2024; 150:16. [PMID: 38240835 PMCID: PMC10798922 DOI: 10.1007/s00432-023-05516-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/21/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND The use of Cyclin-Dependent kinase 4 and 6 (CDK4/6) inhibitors has profoundly changed the challenge of endocrine therapy (ET) resistance in hormone receptor-positive (HR+)/HER2-negative (HER2-) breast cancer. However, there is currently no comprehensive evaluation of the evidence for the efficacy of CDK4/6 inhibitors. We conducted an umbrella review to explore the impact of CDK4/6 inhibitor combined with ET on breast cancer by summarizing and assessing the meta-analysis (MA) and systematic review (SR) evidence. METHODS Cochrane, PubMed, Embase, and Web of Science databases were searched from inception to August 1st, 2022. Eligible studies were assessed for methodological quality, report quality, and evidence quality using the AMSTAR-2 scale, PRISMA 2020, and GRADE grading systems, respectively. We summarized all efficacy outcomes of CDK4/6 inhibitors for breast cancer and reported them in narrative form. RESULTS Our study included 24 MAs and SRs. The strongest evidence demonstrated that CDK4/6 inhibitor combined with ET significantly improved progression-free survival (PFS), overall survival (OS) in advanced breast cancer (ABC). A large body of moderate to high evidence showed a significant association between combination therapy and objective response rate (ORR), and clinical benefit response (CBR) benefit in ABC. Low evidence suggested some degree of benefit from combination therapy in second progression-free survival (PFS2) and time to subsequent chemotherapy (TTC) outcomes in ABC and invasive disease-free survival (IDFS) outcomes in early breast cancer. CONCLUSIONS Based on current evidence, CDK4/6 inhibitors combined with ET have great confidence in improving PFS, OS, ORR, and CBR outcomes in patients with ABC, which provides more rational and valid evidence-based medicine for CDK4/6 inhibitor promotion and clinical decision support.
Collapse
Affiliation(s)
- Dongqing Pu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Debo Xu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yue Wu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hanhan Chen
- Breast Thyroid Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, Shandong, China
| | - Guangxi Shi
- Breast Thyroid Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, Shandong, China
| | - Dandan Feng
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mengdi Zhang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhiyong Liu
- Institute for Literature and Culture of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
- Central Laboratory, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Jingwei Li
- Breast Thyroid Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, Shandong, China.
| |
Collapse
|
18
|
Zheng Y, Zheng H, Guo Z. Comparative efficacy of five traditional Chinese medicine injections for treating heart failure with reduced and mildly reduced ejection fraction: Bayesian network meta-analysis. Heliyon 2024; 10:e23194. [PMID: 38116192 PMCID: PMC10726254 DOI: 10.1016/j.heliyon.2023.e23194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 10/12/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
Background More than half of all heart failure (HF) patients have heart failure with reduced ejection fraction (HFrEF) or mildly reduced ejection fraction (HFmrEF). The combination of traditional Chinese medicine injections (TCMIs) with Western medicine treatment (WMT) has been reported to have better efficacy than using WMT alone. However, the positive effects of TCMIs combined with WMT on HFrEF and HFmrEF require more comprehensive and systematic evidence and warrant further investigation. Methods The NMA searched eight databases, including four English and four Chinese, from database creation to November 10, 2022. We used the Cochrane Risk of Bias tool (ROB 2) to assess the selected studies' quality. OpenBUGS and STATA 17.0 were used for network meta-analysis. Results The 101 RCTs were included in the systematic review. Studies have shown that when combined with any of the five TCMIs, WMT was more efficient than WMT alone. Shenmai injection (SMI) + WMT may be the best treatment for clinical effectiveness rate (CER) improvement and b-type natriuretic peptide (BNP) reduction. Huangqi injection (HQI) + WMT was the best treatment for improving left ventricular ejection fraction (LVEF). Danhong injection (DHI) + WMT may be the best treatment for lowering left ventricular end-diastolic dimension (LVEDD). Xinmailong injection (XMLI) + WMT was likely the best treatment for increasing the 6-min walking test (6MWT). In addition, XMLI had the lowest incidence of adverse reactions (3.38%). Conclusions Shenfu injection (SFI), SMI, DHI, XMLI, and HQI combined with WMT have stronger efficiency in treating HFrEF and HFmrEF. However, as all studies were conducted in China, this review is limited by the inevitable selection bias, and further high-quality multicenter randomized controlled trials (RCTs) are required.
Collapse
Affiliation(s)
- Yu Zheng
- First Clinical College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410007, China
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Huizhen Zheng
- First Clinical College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410007, China
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China
| | - Zhihua Guo
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China
| |
Collapse
|
19
|
Ning JJ, Zuo ZH, Yu ZD, Li XM, Qiao LN. [Safety of modified T-piece resuscitator versus nasal cannula oxygen in electronic bronchoscopy for infants: a prospective randomized controlled study]. Zhongguo Dang Dai Er Ke Za Zhi 2024; 26:37-41. [PMID: 38269457 PMCID: PMC10817733 DOI: 10.7499/j.issn.1008-8830.2309027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To optimize the oxygen therapy regimens for infants with pulmonary diseases during bronchoscopy. METHODS A prospective randomized, controlled, and single-center clinical trial was conducted on 42 infants who underwent electronic bronchoscopy from July 2019 to July 2021. These infants were divided into a nasal cannula (NC) group and a modified T-piece resuscitator (TPR) group using a random number table. The lowest intraoperative blood oxygen saturation was recorded as the primary outcome, and intraoperative heart rate and respiratory results were recorded as the secondary outcomes. RESULTS Compared with the NC group, the modified TPR group had a significantly higher level of minimum oxygen saturation during surgery and a significantly lower incidence rate of hypoxemia (P<0.05). In the modified TPR group, there were 6 infants with mild hypoxemia, 2 with moderate hypoxemia, and 1 with severe hypoxemia, while in the NC group, there were 3 infants with mild hypoxemia, 5 with moderate hypoxemia, and 9 with severe hypoxemia (P<0.05). The modified TPR group had a significantly lower incidence rate of intraoperative respiratory rhythm abnormalities than the NC group (P<0.05), but there was no significant difference in the incidence rate of arrhythmias between the two groups (P>0.05). CONCLUSIONS Modified TPR can significantly reduce the risk of hypoxemia in infants with pulmonary diseases during electronic bronchoscopy, and TPR significantly decreases the severity of hypoxemia and the incidence of respiratory rhythm abnormalities compared with traditional NC.
Collapse
Affiliation(s)
- Jun-Jie Ning
- Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu 610041, China; National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Chengdu 610041, China (Qiao L-N, . cn)
| | - Zhi-Hui Zuo
- Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu 610041, China; National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Chengdu 610041, China (Qiao L-N, . cn)
| | - Zhi-Dong Yu
- Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu 610041, China; National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Chengdu 610041, China (Qiao L-N, . cn)
| | - Xue-Mei Li
- Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu 610041, China; National Health Commission Key Laboratory of Chronobiology (Sichuan University), Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Chengdu 610041, China (Qiao L-N, . cn)
| | | |
Collapse
|
20
|
Wu ZP, Wei ZY, Song XL. Comparison of efficacy between endoscope-assisted anterior cervical discectomy and fusion (ACDF) and open ACDF in the treatment of single-segment cervical spondylotic myelopathy. J Orthop Surg Res 2024; 19:35. [PMID: 38183142 PMCID: PMC10768413 DOI: 10.1186/s13018-023-04514-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/26/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND In this study, we compared the clinical efficacy of endoscope-assisted anterior cervical discectomy and fusion (ACDF) with open ACDF in the treatment of single-segment cervical spondylotic myelopathy. METHODS A retrospective analysis was performed on 52 patients with single-segment cervical spondylotic myelopathy between June 2021 and February 2022, including 33 males and 19 females, with a mean age of 58.42 ± 9.26) years. Among them, 28 patients were treated with endoscope-assisted ACDF (Group A), including 2 cases of C4/5 segment, 16 cases of C5/6 segment, and 10 cases of C6/7 segment; 24 patients were treated with open ACDF (Group B), including 4 cases of C4/5 segment, 11 cases of C5/6 segment, and 9 cases of C6/7 segment. The operation time, intraoperative blood loss, hospital stay, and complications were recorded and compared between the two groups. The Visual Analogue Scale (VAS) and the Japanese Orthopaedic Association (JOA) score were used for clinical evaluation during the follow-up in the 1st month and 3rd month after surgery, and at the final follow-up. RESULTS The 52 patients were followed up on average for 13.04 months (12-17 months). The operation time in Group A and Group B was (105.18 + 8.66) minutes and (81.88 + 6.05) minutes, the intraoperative blood loss was (84.29 + 13.45) mL and (112.92 + 17.81) mL, and the hospital stay was (6.75 + 1.29) days and (7.63 + 1.41) days, respectively. The difference between the two groups was statistically significant (P < 0.05). The VAS and JOA scores in the 1st month and the 3rd month after surgery and the last follow-up significantly improved in both groups compared with those before surgery (P < 0.05). The VAS and JOA scores of Group A in the 1st month, 3rd month after surgery, and the last follow-up were better than those in Group B (P < 0.05). The complication rate in Group A was 7% (2/28), which was not significantly different from the 17% (4/24) in Group B (P > 0.05). CONCLUSION Both endoscope-assisted ACDF and open ACDF can achieve satisfactory clinical efficacy in the treatment of single-segment cervical spondylotic myelopathy. Although the operation time of endoscope-assisted ACDF is prolonged, it has the advantages of clear vision, thorough decompression, less blood loss, and reduced risk of nerve damage, and is worthy of clinical promotion and application.
Collapse
Affiliation(s)
- Zhi-Peng Wu
- Department of Minimally Invasive Spinal Surgery, Angang General Hospital, Middle Section of Gangsan Road, Yindu District, Anyang, 445000, China
| | - Zhao-Yong Wei
- Department of Minimally Invasive Spinal Surgery, Angang General Hospital, Middle Section of Gangsan Road, Yindu District, Anyang, 445000, China
| | - Xiao-Lei Song
- Department of Minimally Invasive Spinal Surgery, Angang General Hospital, Middle Section of Gangsan Road, Yindu District, Anyang, 445000, China.
| |
Collapse
|
21
|
Wang L, Wang T, Fan N, Yuan S, Du P, Si F, Wang A, Zang L. Clinical outcome of percutaneous endoscopic lumbar decompression in treatment of elderly patients with lumbar spinal stenosis: a matched retrospective study. Int Orthop 2024; 48:201-209. [PMID: 37632530 DOI: 10.1007/s00264-023-05947-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE This retrospective cohort study aimed to evaluate the efficacy and safety of percutaneous endoscopic lumbar decompression (PELD) in elderly patients with lumbar spinal stenosis (LSS). STUDY DESIGN A matched retrospective study. SETTING The research was conducted in Beijing Chaoyang Hospital, Capital Medical University, China. METHODS This study included patients treated with PELD for LSS from September 2016 to September 2020. Patients with LSS aged ≥ 80 years were screened according to the inclusion and exclusion criteria as the study group, and then the same number of patients with LSS aged 50-80 years were matched according to gender, stenosis type, and surgical segment as the control group. Preoperative patient status was assessed using the Charlson comorbidity index (CCI) and the American Society of Anesthesiologists (ASA) physical status classification score. Clinical outcomes were assessed using the visual analog scale (VAS), Oswestry Disability Index (ODI) scores, modified Macnab criteria, radiological parameters and complication rates. RESULTS A total of 624 LSS patients met the screening criteria between September 2016 and September 2020, with 47 LSS patients ≥ 80 years old serving as the study group. Forty-seven LSS patients aged 50-80 years were matched to the study group according to gender, stenosis type, and stenosis segment. The CCI score (1.77 ± 1.67) and ASA classification (2.62 ± 0.74) of the study group were significantly higher than the CCI score (0.66 ± 0.96) and ASA classification (1.28 ± 0.54) of the control group, and the difference was statistically significant. Compared with preoperative data, postoperative ODI, leg pain VAS scores and back pain VAS scores were significantly improved in both groups (p < 0.05). However, no significant difference was found between two groups in preoperative and postoperative ODI, leg pain VAS scores and back pain VAS scores (p > 0.05). The operation time and postoperative hospital stay in control group were significantly lower than those in study (p < 0.05), but there was no significant difference in blood loss between the two groups (p > 0.05). Besides, overall radiological parameters were comparable in elder and younger patients (p > 0.05), and disc height (DH), lumbar lordosis and segmental lordosis decreased after two year follow-up in both groups (p < 0.05). In addition, complication rates were similar between the two groups (p > 0.05), and no serious complications and deaths were found. LIMITATIONS Single-centre retrospective design, non-randomized sample, small sample size. CONCLUSION Although elderly LSS patients (≥ 80 years old) are less fit and have more comorbidities, satisfactory outcomes can be achieved with PELD, comparable to those of LSS patients < 80 years old, and without increased complications.
Collapse
Affiliation(s)
- Lei Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Tianyi Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Ning Fan
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Shuo Yuan
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Peng Du
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Fangda Si
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Aobo Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Lei Zang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China.
| |
Collapse
|
22
|
Lacaita PG, Barbieri F, Plank F, Beyer C, Friedrich G, Widmann G, Feuchtner G. Prediction of high coronary artery calcium (CAC) scores from aortic arch calcification: An efficient tool for selection of non-optimal candidates for coronary CTA? Eur J Radiol 2024; 170:111216. [PMID: 38029704 DOI: 10.1016/j.ejrad.2023.111216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Overutilization of healthcare resources is causing a high socioeconomic burden. Patients with high coronary artery calcium (CAC) scores > 1000AU are not optimal candidates for coronary CTA and better suited for other diagnostic strategies. Therefore, our objective was to evaluate whether a 4-scale aortic arch calcification severity (AoArCa) score from CT and X-Ray predicts high-CAC scores. METHODS Patients referred to coronary/aortic CT-Angiography were enrolled. The severity of aortic arch calcification (AoArCa) was scored as grade: 0 = absent, 1 = minimal (<25 % of circumference), 2 = mild (25-50 %), 3 = moderate (50-75 %) and 4 = severe (75-100 %) on both thoracic CT and X-ray. RESULTS In 130 patients, the absence of AoArCa by CT was highly accurate to rule out CAC > 1000AU (sens. 100 %). No or minimal AoArCa had a high NPV of 95.6 % to rule out CAC > 1000 and grade 0,1 + 2 a NPV of 86.96 %. The AUC of AoArCa by CT for predicting high CAC > 1000 was c = 0.84 (p < 0.001; 95 %CI: 0.771--0.91). For moderate-to-severe AoArCa, accuracy was c = 0.792 (p < 0.001). The intermodality agreement between CT and X-Ray based AoArCa Scores was good (r = 0.824, p < 0.001); ICC = 0.902. For X-ray, AUC was c = 0.715 to predict CAC > 1000 (p < 0.001). In regression models, only moderate-or-severe AoArCa, but not the other CVRF predicted CAC > 1000 (p < 0.001), and there was an association of the number of CVRF. CONCLUSIONS Patients with moderate-to-severe aortic arch calcification have a high probability of CAC > 1000AU, but not those with no, minimal and mild. The absence of AoArCa rules out CAC > 1000AU. AoArCa severity may serve as valuable tool for selecting the diagnostic strategy.
Collapse
Affiliation(s)
| | - Fabian Barbieri
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Fabian Plank
- Department of Internal Medicine, Tyrol Clinicum Hall, Austria
| | - Christoph Beyer
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Guy Friedrich
- Department of Internal Medicine, Cardiology, Medical University Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Gudrun Feuchtner
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
| |
Collapse
|
23
|
Huang M, Du H, Lai J, Huang X, Xie W, Wu Y, Chen B, Li Y, Gao F, Huang W, Li G, Chen D, Liang G, Li Z, Liu Q, Ding B. Clinical efficacy of Kuanxiong aerosol for patients with prehospital chest pain: A randomized controlled trial. Phytomedicine 2024; 123:155206. [PMID: 38091825 DOI: 10.1016/j.phymed.2023.155206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Kuanxiong Aerosol (KXA)(CardioVent®), consisting of Asarum sieboldii Miq. oil, Santalum album L. oil, Alpinia officinarum Hance oil, Piper longum L. oil and borneol, seems to relieve the symptoms of chest pain and serve as a supplementary treatment for prehospital chest pain in emergency department. STYLE OF THE STUDY This randomized controlled trial aimed to determine the clinical effect and safety of KXA for patients with prehospital chest pain. METHODS A total of 200 patients were recruited from Guangdong Provincial Hospital of Chinese Medicine and randomly divided into KXA group (n = 100) and Nitroglycerin Aerosol (NA) group (n = 100) by SAS 9.2 software. All patients were treated with standardized Western medicine according to the pre-hospital procedure. The experimental group and NA group was additionally treated with KXA and NA respectively. The primary outcome was the relieving time of prehospital chest pain (presented as relief rate) after first-time treatment. The secondary outcomes included the evaluation of chest pain (NRS scores, degree of chest pain, frequency of chest pain after first-time treatment), efficacy in follow-up time (the frequency of average aerosol use, emergency department visits, 120 calls, medical observations and hospitalization at 4 weeks, 8 weeks, 12 weeks), alleviation of chest pain (Seattle angina questionnaire, chest pain occurrence, and degree of chest pain at 12-weeks treatment) and the change of TCM symptoms before and after 12-weeks treatment. In addition, the safety of KXA was also assessed by the occurrence of adverse events. The database was created using Epidata software, and statistical analysis was conducted by SPSS 23.0 software. RESULTS A total of 194 participants finally completed the trial, the results showed that after first-time treatment, KXA had a higher relief rate (72.2%) of chest pain within 30 min than that of NA group (59.4%, p = 0.038), KXA group had a lower degree of chest pain (p = 0.005), lower NRS score (p = 0.011) and higher reduction of NRS score (p = 0.005) than the NA. In the follow-up period, KXA group decreased the frequency of 120 call better than that of NA group at 4 weeks (p = 0.040), but KXA had a similar efficacy as NA in the improvement on the of frequency of chest pain, aerosol use, emergency department visits, 120 call, medical observation and hospitalization at 4 weeks, 8 weeks and 12 weeks (p>0.05). There also had no difference between the two groups on the occurrence of chest pain, degree of chest pain, physical limitation, angina stability, treatment satisfaction, and disease perception between the two groups at 12 weeks (p>0.05). In addition, KXA and NA both improved the patient's chest pain, but not the TCM symptoms. In terms of safety, KXA showed similar safety as NA in this study. CONCLUSIONS KXA relieved prehospital chest pain faster than NA and had a better remission effect on the prehospital chest pain than that of the NA group in short-period. In long-period, KXA showed similar efficacy on the improvement of prehospital chest pain as NA. KXA may be a safe and reliable therapy for prehospital chest pain.
Collapse
Affiliation(s)
- Manhua Huang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China; Second Clinical Medical College of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Hongjin Du
- Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jiahua Lai
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Xiaoyan Huang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Wenyuan Xie
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Yanhua Wu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Baijian Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Yonglin Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Feng Gao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Wei Huang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Guowei Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Dunfan Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Guorong Liang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Zunjiang Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China; Second Clinical Medical College of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China
| | - Quanle Liu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China; Second Clinical Medical College of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China.
| | - Banghan Ding
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China; Second Clinical Medical College of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou, Guangdong, China.
| |
Collapse
|
24
|
Chen H, Liu Y, Huang D, Zhang X, She L. Total thyroidectomy versus unilateral lobectomy for unilateral multifocal papillary thyroid carcinoma: systematic review and meta‑analysis. Updates Surg 2024; 76:33-41. [PMID: 38127193 DOI: 10.1007/s13304-023-01726-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
The optimal surgical procedure(s) for unilateral multifocal papillary thyroid carcinomas is currently controversial. As such, the present study aimed to compare the efficacies of total thyroidectomy and lobectomy in patients with unilateral multifocal papillary thyroid carcinoma. A literature search of the PubMed/Medline, Embase, Web of Science, Cochrane Library, Wan Fang, and Zhi Wang databases for relevant studies, published from inception to October 31, 2022, was performed. Two researchers independently extracted data from the included studies. Lymph node metastasis, vocal fold paralysis, parathyroid injury, postoperative recurrence, and disease-free survival were evaluated. The meta-analysis included 7 studies comprising 1540 patients, of whom 496 and 1044 underwent lobectomy and total thyroidectomy, respectively. Compared with lobectomy, total thyroidectomy resulted in more vocal cord paralysis (odds ratio [OR] 0.35 [95% confidence interval (CI) 0.13 to 0.96]; P = 0.04) and parathyroid injury (OR 0.11 [95% CI 0.03-0.39]; P = 0.001) but with better disease-free survival (OR 0.21 [95% CI 0.09-0.49]; P = 0.000), although vocal cord paralysis and parathyroid injury, in large part, resolved within 1 year after surgery. In addition, there was no difference in postoperative lymph nodes metastasis (OR 0.74 [95% CI 0.13-4.21]; P = 0.737) and postoperative recurrence (OR 2.37 [95% CI 0.42-13.38]; P = 0.33). Excluding studies that deviated from the general trend, total thyroidectomy was beneficial in reducing recurrence. Compared with lobectomy, total thyroidectomy was beneficial in reducing recurrence and disease-free survival and may be considered a more optimal approach for unilateral multifocal papillary thyroid carcinoma.
Collapse
Affiliation(s)
- Huihong Chen
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
| | - Yong Liu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), 87 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Donghai Huang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
| | - Xin Zhang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), 87 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Li She
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China.
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China.
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China.
| |
Collapse
|
25
|
Sun H, Xiong S, Zhang Y, Zhao Q, Wu Z, Xiao L. Clinical significance of redundant nerve roots in patients with lumbar spinal stenosis undergoing oblique lumbar interbody fusion combined with percutaneous internal fixation. J Orthop Surg Res 2023; 18:958. [PMID: 38087350 PMCID: PMC10717461 DOI: 10.1186/s13018-023-04449-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND While there have been previous studies on the surgical efficacy of patients with redundant nerve roots (RNRs), a persistent issue is that some patients continue to experience redundancy even after surgery. Furthermore, the clinical significance of RNRs remains unclear. Notably, there is a lack of research regarding RNRs within the context of oblique lumbar interbody fusion (OLIF) combined with percutaneous internal fixation. Therefore, the primary objective of this study is to investigate the correlation between RNRs and clinical outcomes following OLIF combined with percutaneous internal fixation. METHODS Eighty-seven patients diagnosed with lumbar spinal stenosis (LSS) who underwent single-segment OLIF combined with percutaneous internal fixation were categorized into three groups. Group 1 comprised patients with positive RNRs both before and after the operation. Group 2 included patients with positive RNRs preoperatively but negative RNRs postoperatively. Group 3 consisted of patients with consistently negative RNRs before and after the operation. Comprehensive patient data were collected, including operation time, intraoperative blood loss, and any recorded complications. Radiographic parameters, both pre- and post-operative, were assessed, encompassing the number of stenosis segments, disc height (DH), lumbar lordotic angle, dural sac cross-sectional area, and the placement of the fusion cage. Furthermore, the Visual Analogue Scale was applied to gauge back and leg pain, while the Oswestry Disability Index was employed to appraise daily living activities. A comparative analysis was carried out among the three patient groups. RESULTS In this study, all 87 LSS patients successfully underwent surgery. Among them, 35 patients (40.2%) showed preoperative MRI assessment indicating positive RNRs. In the postoperative MRI assessment, 14 of these patients maintained positive RNRs status, and they were grouped into Group 1. The remaining 21 patients saw a transition to negative RNRs status and were included in Group 2. Among the 52 patients who had preoperative MRI assessments showing negative RNRs, their postoperative RNRs status remained negative, forming Group 3. All patients received follow-up, which ranged from 8 to 18 months, and no complications occurred during this period. In this study, the postoperative efficacy and parameters such as DH and Dural Sac CSA significantly improved compared to preoperative values for all 87 patients. Patients with preoperative RNRs had more stenosis segments, smaller dural sac CSA, and more severe symptoms. In all three groups, postoperative efficacy scores significantly improved compared to preoperative scores. Group 2 patients had their fusion cages placed more in the middle, while Group 1 patients had their fusion cages more anteriorly located. Group 2 patients exhibited greater recovery in dural sac CSA postoperatively compared to Group 1 patients. Additionally, Group 2 patients had better ODI efficacy scores compared to Group 1 patients. CONCLUSIONS Irrespective of the presence or absence of RNRs, patients experienced improvement after undergoing OLIF combined with percutaneous internal fixation. Preoperative RNRs appear to be linked to multi-segmental lumbar spinal stenosis, a reduction in dural sac CSA, and symptom severity. Patients with negative postoperative RNRs demonstrated better treatment efficacy. Furthermore, the placement of the fusion cage appears to have a significant impact on postoperative efficacy and RNRs outcomes.
Collapse
Affiliation(s)
- Hongzhou Sun
- Department of Spine Surgery, Yijishan Hospital, The First Affliated Hospital of Wannan Medical College, Wuhu, China
| | - Shouliang Xiong
- Department of Joint Surgery, Yijishan Hospital, The First Affliated Hospital of Wannan Medical College, Wuhu, China
| | - Yu Zhang
- Department of Spine Surgery, Yijishan Hospital, The First Affliated Hospital of Wannan Medical College, Wuhu, China
| | - Quanlai Zhao
- Department of Spine Surgery, Yijishan Hospital, The First Affliated Hospital of Wannan Medical College, Wuhu, China
| | - Zhongxuan Wu
- Department of Spine Surgery, Yijishan Hospital, The First Affliated Hospital of Wannan Medical College, Wuhu, China
| | - Liang Xiao
- Spine Research Center of Wannan Medical College, No. 22 Wenchang West Road, Wuhu, 241001, China.
| |
Collapse
|
26
|
Han NR, Osman A, Hu W, Huang YF, Liu YL, Ma ZJ. Effect of spinal orthosis on clinical outcomes of patients after oblique lumbar interbody fusion: a randomized controlled trial study protocol. Trials 2023; 24:787. [PMID: 38049917 PMCID: PMC10696774 DOI: 10.1186/s13063-023-07796-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/09/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Oblique lumbar interbody fusion (OLIF) is an internationally popular minimally invasive technology for the treatment of various lumbar diseases. Since its introduction to China in 2014, OLIF technology has clearly shown its superiority in reconstructing intervertebral stability, restoring intervertebral space height, achieving indirect decompression, and restoring normal lumbar sequence. However, some patients still suffer from persistent symptoms after OLIF, including low back pain and soreness, which indirectly affect the overall surgical efficacy and patient satisfaction. Therefore, some clinicians recommend that patients routinely use spinal orthoses after OLIF to reduce the stress on the lower back muscles and ligaments, thereby relieving or avoiding postoperative residual symptoms or new symptoms. Accordingly, spinal orthosis use after OLIF has emerged as an essential option. However, the role of spinal orthoses in OLIF and their specific impact on postoperative patient clinical outcomes have remained unclear, and there is a lack of strong clinical evidence to indirectly or directly support the role of spinal orthoses in OLIF and demonstrate their impact on patient clinical outcomes. This study aims to investigate the role of spinal orthoses in OLIF by grouping patients based on the use or nonuse of spinal orthosis after OLIF, thus providing a better basis for the majority of patients and physicians. METHODS/DESIGN We plan to conduct a 1-year randomized controlled trial involving 60 subjects. The subjects will be randomized into two groups: group A (those wearing spinal orthoses after surgery) and group B (those not wearing spinal orthoses after surgery). The clinical outcomes of these patients will be evaluated using the Oswestry disability index, visual analog scale, and Brantigan, Steffee, Fraser 1 day before surgery and 2 weeks and 1, 6, and 12 months after surgery. DISCUSSION This randomized controlled trial aims to provide a reference for further comprehensive trial design. The findings of this study will provide a better and more scientific basis for the choice of postoperative rehabilitation and treatment for patients undergoing such a procedure. TRIAL REGISTRATION This study has been registered in the Chinese Clinical Trial Registry (Registration No.: ChiCTR2200059000). Registration date: April 22, 2022. Registration website: http://www.chictr.org.cn/showproj.aspx?proj=166310.
Collapse
Affiliation(s)
- Nian-Rong Han
- Xinjiang Medical University, 393 Xinyi Rd, Xinshi District, Ürümqi, Ürümqi, 830011, Xinjiang, China
| | - Akram Osman
- Xinjiang Medical University, 393 Xinyi Rd, Xinshi District, Ürümqi, Ürümqi, 830011, Xinjiang, China
| | - Wei Hu
- Xinjiang Medical University, 393 Xinyi Rd, Xinshi District, Ürümqi, Ürümqi, 830011, Xinjiang, China.
| | - Yi-Fei Huang
- Xinjiang Medical University, 393 Xinyi Rd, Xinshi District, Ürümqi, Ürümqi, 830011, Xinjiang, China
| | - Yan-Lu Liu
- Xinjiang Medical University, 393 Xinyi Rd, Xinshi District, Ürümqi, Ürümqi, 830011, Xinjiang, China
| | - Zhan-Jun Ma
- Xinjiang Medical University, 393 Xinyi Rd, Xinshi District, Ürümqi, Ürümqi, 830011, Xinjiang, China
| |
Collapse
|
27
|
Feng Z, Wu Y, Wu H, Jon TG, Yuan Y, Chen Z, Wang Y. A Modified Laminotomy for Interlaminar Endoscopic Lumbar Discectomy: Technical Report and Preliminary Results. Neurospine 2023; 20:1513-1523. [PMID: 38171317 PMCID: PMC10762391 DOI: 10.14245/ns.2346572.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE To introduce a technique of laminotomy using a common trephine to enlarge the interlaminar space at L4/5 segment for interlaminar endoscopic lumbar discectomy (IELD) and report the anatomical basis of this procedure, technical details, as well as primary clinical outcomes of a consecutive patient cohort with L4/5 lumbar disc herniation (LDH). METHODS On anteroposterior fluoroscopy, the intersection of the medial edge of the inferior articular process and the inferior endplate of L4 vertebra was taken as the target. Using a common trephine, laminotomy was performed to remove a big portion of the posterior wall of the canal under the guidance of endoscopy. From June 2018 to December 2021, the consecutive patients who underwent L4/5 IELD were prospectively studied. Clinical outcomes were assessed at the day before surgery, 1 day, 1 month, 3 months, 12 months after surgery, and the last follow-up. Numerical Rating Scale, Roland-Morris Disability Questionnaire (RMDQ), and MacNab criteria were used to evaluate back and leg pain, the quality of life, and clinical efficacy, respectively. RESULTS There were 64 men and 44 women, with an age of 50.3 ± 14.9 years. The operating time was 74.54 ± 17.42 minutes. The mean follow-up time was 32.7 ± 18.6 months (range, 12-64 months). The complications of IELD included numbness, neck pain, and recurrence. Both leg pain (6.2 ± 1.9 vs. 1.8 ± 0.8, p < 0.001) and back pain (3.1 ± 2.3 vs. 1.7 ± 0.9, p < 0.001) quickly improved after this procedure and maintained (1.1 ± 1.5, 1.1 ± 1.3) at final follow-up. Physical disability due to back pain, as assessed using RMDQ, was improved remarkably after surgery (15.0 ± 5.8 vs. 2.9 ± 4.1, p < 0.001). In addition, MacNab outcome grade was evaluated as good-to-excellent in 96 cases (88.9%). CONCLUSION A convenient technique of laminotomy using a common trephine was proposed for the L4/5 IELD. It can efficiently enlarge the interlaminar entry to perform endoscopic discectomy. This procedure is particularly suitable for treating LDH with concomitant lumbar spinal stenosis and migrated herniated disc.
Collapse
Affiliation(s)
- Zhiyun Feng
- Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuxu Wu
- Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Honghao Wu
- Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tae Gyong Jon
- Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Yuan
- Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhong Chen
- Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yue Wang
- Spine Lab, Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
28
|
Liu S, Feng J, Ren Q, Qin H, Yang W, Cheng H, Yao X, Xu J, Han J, Chang S, Yang S, Mou J, Lin Y, He L, Wang H. Evaluating the clinical efficacy and limitations of indocyanine green fluorescence-guided surgery in childhood hepatoblastoma: A retrospective study. Photodiagnosis Photodyn Ther 2023; 44:103790. [PMID: 37696318 DOI: 10.1016/j.pdpdt.2023.103790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/20/2023] [Accepted: 09/06/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Indocyanine green (ICG) fluorescence guided surgery has been used to treat childhood hepatoblastoma (HB), but the advantages and disadvantages of this technique have not been fully discussed. The purpose of this study is to summarize the experience and to explore the clinical value of this technique for children with HB. METHODS 45 children with HB who underwent ICG fluorescence guided surgery (n = 22) and general surgery (n = 23) in our center from January 2020 to December 2022 were enrolled retrospectively. RESULTS All the liver tumors in the ICG group showed hyperfluorescence, including total and partial fluorescent types. With the help of ICG navigation, minimally invasive surgery was performed in 3 cases. 18.2 % of cases with tumors could not be accurately identified under white light, but could be identified by fluorescence imaging. The fluorescent cutting lines of 59.1 % of cases were consistent with the safe cutting lines. In 36.4 % of cases, the fluorescence boundary was not clear because of tumor necrosis. In 36.4 % of cases, the fluorescence could not be detected on the inner edge of the tumors because of the depth. A total of 29 ICG (+) suspicious lesions were found during the operations, of which 5 were true positive lesions. CONCLUSION ICG fluorescence guided surgery is safe and feasible in children with HB. This technique is helpful for locating tumors, determining margin and finding small lesions with negative imaging, especially in minimally invasive surgery. However, preoperative chemotherapy, tumor necrosis, tumor depth, and ICG administration impact the effect of fluorescence imaging.
Collapse
Affiliation(s)
- Shan Liu
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Jun Feng
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Qinghua Ren
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Hong Qin
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China.
| | - Wei Yang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China.
| | - Haiyan Cheng
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Xingfeng Yao
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Jiatong Xu
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Jianyu Han
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Saishuo Chang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Shen Yang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Jianing Mou
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Yu Lin
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China
| | - Lejian He
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Huanmin Wang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 NanLishi Road Xicheng District, Beijing 100045, China.
| |
Collapse
|
29
|
Wang H, Wu Y, Huang P, Chen W, Wang Z, Wang Y. Comparison of effectiveness and safety of Da Vinci robot's "3 + 1" and "4 + 1" modes of treatment for colorectal cancer. J Robot Surg 2023; 17:2807-2815. [PMID: 37735326 DOI: 10.1007/s11701-023-01717-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/03/2023] [Indexed: 09/23/2023]
Abstract
To compare the effectiveness of the Da Vinci Surgical Robot System (DSRS) "3 + 1" and "4 + 1" models for colorectal cancer (CRC). A total of 107 patients with CRC admitted to our hospital from February 2021 to May 2022 were selected for the retrospective analysis. Of these, 57 patients underwent the DSRS "4 + 1" model (control group), while the rest 50 underwent the DSRS "3 + 1" model (research group). The operation time, intraoperative bleeding, number of lymph nodes detected, time of first postoperative urinary catheter removal, time of first feeding, time of first venting and hospitalization were compared between the two groups. The changes of white blood cell (WBC) and C-reactive protein (CRP) levels before and after surgery were detected, and patients' adverse effects and treatment costs between surgery and hospital discharge were counted. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to assess the psychological state of the patients. There was no difference in operative time, intraoperative bleeding, and number of lymph nodes detected between both groups (P > 0.05), while time to first postoperative urinary catheter removal, time to first feeding, time to first venting, length of stay (LOS), postoperative inflammatory factor levels, incidence of adverse events, and treatment costs were all lower in the research group than in the control group (P < 0.05). SAS and SDS scores decreased after treatment in both groups, but the decrease was more obvious in the research group (P < 0.05). Both DSRS "4 + 1" and "3 + 1" modes have better treatment effects for CRC. However, the "3 + 1" mode has higher safety and lower treatment cost, which can significantly improve the postoperative recovery process of patients and is more worthy to be promoted in clinical practice.
Collapse
Affiliation(s)
- Huaiwen Wang
- Department of Anorectal Surgery, Hainan Provincial People's Hospital, Haikou, 570311, Hainan, China.
| | - Yuanhao Wu
- Department of Anorectal Surgery, Hainan Provincial People's Hospital, Haikou, 570311, Hainan, China
| | - Ping Huang
- Department of Anorectal Surgery, Hainan Provincial People's Hospital, Haikou, 570311, Hainan, China
| | - Weijia Chen
- Department of Anorectal Surgery, Hainan Provincial People's Hospital, Haikou, 570311, Hainan, China
| | - Zhenfen Wang
- Department of Anorectal Surgery, Hainan Provincial People's Hospital, Haikou, 570311, Hainan, China
| | - Yuna Wang
- Department of Anorectal Surgery, Hainan Provincial People's Hospital, Haikou, 570311, Hainan, China
| |
Collapse
|
30
|
Hooda N, Ahlawat A, Kumari P, Alam S, Ansari JR. Role of Nanomedicine for Targeted Drug Delivery in Livestock: Future Prospective. Pharm Nanotechnol 2023; 12:PNT-EPUB-136374. [PMID: 38018187 DOI: 10.2174/0122117385267911231109184511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/03/2023] [Indexed: 11/30/2023]
Abstract
Nanotechnology has advanced significantly in recent years and is currently used in a wide range of sectors. Only a handful of the many diverse issues covered by nanotechnology include nanoscale gadgets, nanomaterials, nanoparticles, and nanomedicines. Its performance in treating a range of grave conditions, such as cancer, early detection of infections, analysis, bio-imaging, and bio sensing, suggests that it is highly advanced. Nanoscale materials have been employed for medicine delivery, pharmaceutics, and a range of diagnostic techniques due to their various biochemical and physical features. The use of nanoparticles that are based on nanotechnology can significantly improve the drug delivery mechanism. It is believed that nanoparticles capacity to improve the stability and solubility of drugs and shield them from impulsive inactivation during drug transfer makes it possible for them to capture, encapsulate, or bond with the molecules. The use of nanomedicine or nanoparticle-based tactics to combat viruses has emerged as a potentially life-saving tactic. These approaches have the power to protect both humans and animals against viruses. In order to inactivate a virus, nanoparticles have the unique capacity to connect with the virus epitope. Many nanocarriers have the potential to replace current drug delivery methods with focused drug delivery. Small dosages, low toxicity, and targeted flow of drug release at the infected location are all characteristics of nanocarriers or nanomedicine. Due to their distinct physicochemical and biological features, nanomaterial-based drug delivery systems (NBDDS) are frequently employed to enhance the safety and therapeutic efficacy of encapsulated pharmaceuticals. The program's objective can be supported by the applications that have so far been developed. This idea is therefore essential and sophisticated for the development of civilization. Our research will therefore concentrate on how human use of nanomedicines has changed through time in many domains.
Collapse
Affiliation(s)
- Neeti Hooda
- Department of Chemistry, P.D.M. University, Bahadurgarh, Haryana, 124001, India
| | - Aarti Ahlawat
- Department of Chemistry, P.D.M. University, Bahadurgarh, Haryana, 124001, India
| | - Puja Kumari
- GT College of Pharmacy, SGT University, Gurgaon-Badli Road Chandu, Budhera, Gurugram, Haryana, 122505, India
| | - Sabir Alam
- GT College of Pharmacy, SGT University, Gurgaon-Badli Road Chandu, Budhera, Gurugram, Haryana, 122505, India
| | - Jamilur R Ansari
- Functional Packaging Materials Lab, Department of Packaging, School of Science and Technology, Yonsei University, 1 Yonseidae-gil, Wonju-si, Gangwon-do, 26493, Republic of Korea
| |
Collapse
|
31
|
Liu HJ, Wang QY, Niu CL, Wang GS, Huang GY. [Clinical application study of multiple small-diameter drilling combined with extracorporeal shock wave therapy (ESWT) under C-arm positioning in the treatment of early femoral head necrosis]. Zhongguo Gu Shang 2023; 36:1014-20. [PMID: 38012867 DOI: 10.12200/j.issn.1003-0034.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To explore the therapeutic effect of multiple small diameter drilling combined with extracorporeal shock wave therapy (ESWT) under C-arm X-raylocalization in patients with early osteonecrosis of the femoral head (ONFH). METHODS A total of 106 cases of early ONFH patients admitted from May 2015 to May 2017 were retrospectively selected as the study subjects. According to different treatment methods, the patients were divided into observation group and control group, 53 cases in each group. The observation group was treated with multiple small-diameter drilling combined with ESWT under C-arm positioning in the observation group, including 41 males and 12 females with an age of (45.85±6.01) years old (22 to 70 years old);and the control group was treated with ESWT, including 34 males and 19 females with an age of (45.12±5.83) years old(20 to 68 years old) in the control group. The modified Harris hip scores(mHHS), visual analog scale(VAS), hip flexion range, hip abduction and adduction range, ONFH area ratio and clinical efficacy were compared between twe groups before and after treatment. Kaplan-Meier method was used to draw a survival curve to compare the femoral head survival rate between two groups during the 3-year follow-up period after treatment. RESULTS There were no complications such as poor wound healing and infection. All of 106 patients were followed up for 28 to 36 months with an average of (31.06±4.28) months. MHHS score, hip flexion range and hip abduction and adduction range in the observation group were increased from (63.85±5.42) scores, (23.79±2.21) °, (32.40±4.19) ° before treatment to (85.51±5.69) scores, (34.65±2.73)°, (43.32±5.71)° at 2 years after treatment, respectively(P<0.05). The above indicators in the control group increased from (64.73±5.64)°, (23.82±2.18)°, (32.45±4.13)° before treatment to (81.65±5.48) scores, (32.79±2.87)°, (39.75±5.68)°at two years after treatment, respectively(P<0.05). VAS score and ONFH area ratio in the observation group decreased from (5.76±1.41) scores and (35.07±4.96)% before treatment to (3.39±1.02) scores and (22.04±3.23)% at 2 years after treatment, respectively(P<0.05). The above indicatiors in control group decreased from (5.73±1.45) scores and (35.24±5.18)% before treatment to (4.43±1.21) scores and (28.32±3.76)% at 2 years after treatment, respectively(P<0.05), and the improvement in the observation group was significantly higher than that in the control group(P<0.05). At 3 years after treatment, the femoral head survival rate in the observation group was higher than that in the control group (P<0.05). CONCLUSION Multiple small diameter drilling combined with ESWT under C-arm positioning can significantly improve the clinical symptoms of patients with early ONFH, relieve pain and improve clinical efficacy.
Collapse
Affiliation(s)
- Hai-Jun Liu
- Department of Orthopaedics, Wuwei People's Hospital, Wuwei 733000, Gansu, China
| | - Qian-Yuan Wang
- Department of Orthopaedics, Wuwei People's Hospital, Wuwei 733000, Gansu, China
| | - Cun-Liang Niu
- Department of Orthopaedics, Wuwei People's Hospital, Wuwei 733000, Gansu, China
| | - Geng-Shen Wang
- Department of Orthopaedics, Wuwei People's Hospital, Wuwei 733000, Gansu, China
| | - Guo-Yuan Huang
- Department of Orthopaedics, Wuwei People's Hospital, Wuwei 733000, Gansu, China
| |
Collapse
|
32
|
Yang H, Du R, Xing X, Li Y, Qiu B. Efficacy and influencing factor analysis of Voriconazole in the treatment of invasive fungal infections. Diagn Microbiol Infect Dis 2023; 107:116047. [PMID: 37688949 DOI: 10.1016/j.diagmicrobio.2023.116047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/06/2023] [Accepted: 07/28/2023] [Indexed: 09/11/2023]
Abstract
Current study aims to explore the correlation between the administered dose and efficacy of voriconazole in the treatment of invasive fungal infection (IFI). The correlation between different doses of Voriconazole and plasma concentrations as well as clinical efficacy was counted. Consequently, 40 strains of pathogenic micro-organisms were isoninelated and cultured from etiological samples. A total of 66 patients with steady-state trough serum concentrations ranging from 1.0 to 5.5 μg/mL were measured, with a compliance rate of 79.5%. Chi-square test showed that there was a significant correlation between Voriconazole steady-state serum trough concentration and treatment efficacy. In addition, the result of Pearson test showed that steady-state trough serum concentration of Voriconazole was significantly positively correlated with the administered dose (γ = 0.866, P < 0.001). On conclusion, Voriconazole is effective in treatment of IFI, and there is a significant dose-plasma concentration correlation with efficacy.
Collapse
Affiliation(s)
- Haotian Yang
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Runxuan Du
- Department of Reproductive Genetics, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xiaoqing Xing
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Ying Li
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Bo Qiu
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei, China.
| |
Collapse
|
33
|
Lee YH, Song GG. Efficacy of initiating urate-lowering therapy during an acute gout episode: a meta-analysis. Z Rheumatol 2023; 82:763-769. [PMID: 37233824 DOI: 10.1007/s00393-023-01366-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of initiating urate-lowering therapy (ULT) during acute gout episodes. METHODS We performed a literature search using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (from inception to February 2023). We conducted a comprehensive review and meta-analysis of randomized controlled trials (RCTs) that examined the efficacy of ULT in individuals with acute gout flares. RESULTS This review included six RCTs with 479 patients (225 experimental participants and 254 controls). The experimental group had longer days to resolution than did the control group. There was no significant difference in the pain visual analogue scale score between the groups by day 10. Erythrocyte sedimentation rate and C‑reactive protein level did not significantly differ between the groups by days 7 to 14. Both groups had similar rates of recurrent gout attacks by 30 days. There was no significant between-group difference in the dropout rate. CONCLUSION Initiating ULT therapy during a gout attack does not appear to increase the duration of the flare or aggravate pain. Despite these findings, further studies with larger sample sizes are necessary to support these conclusions.
Collapse
Affiliation(s)
- Young Ho Lee
- Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, 02841, Seongbuk-gu, Seoul, Korea (Republic of).
| | - Gwan Gyu Song
- Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, 02841, Seongbuk-gu, Seoul, Korea (Republic of)
| |
Collapse
|
34
|
Luchetti Gentiloni MM, Paci V, Carletto A, Zabotti A, Ramonda R, Chimenti MS, Dagna L, Luciano N, Piccinelli A, Giovannini I, Striani G, Boffini N, Sandri G, Possemato N, Pantano I, Benfaremo D, Salvarani C, Ciccia F, Selmi C, Moroncini G. Upadacitinib effectiveness and factors associated with minimal disease activity achievement in patients with psoriatic arthritis: preliminary data of a real-life multicenter study. Arthritis Res Ther 2023; 25:196. [PMID: 37821952 PMCID: PMC10565976 DOI: 10.1186/s13075-023-03182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Upadacitinib (UPA) is a selective JAK inhibitor recently approved for the treatment of psoriatic arthritis (PsA). In this post-approval study, we aimed to evaluate the effectiveness and safety of UPA over 24 weeks and identify clinical predictors of response, in a multicentric cohort of patients affected by PsA. METHODS One hundred and twenty-six patients with PsA treated with UPA were enrolled in 10 Italian centres. UPA effectiveness outcomes, such as the proportion of patients with MDA status, DAPSA remission, and low disease activity, ASDAS-CRP inactive and low disease activity, and change from baseline in DAPSA and ASDAS-CRP scores, were evaluated every 12 weeks until week 24. The proportion of DAPSA minor, moderate, and major improvement, and ASDAS clinically important improvement (CII) and major improvement (MI) were considered as well. All treatment-related adverse events were collected during the observation period. Clinical predictors of MDA response at week 24 were evaluated through multivariate analysis. RESULTS At baseline, 124/126 (98%) and 54/126 (43%) patients showed peripheral and axial involvement, respectively; 110 (87%) patients were intolerant or resistant to biologic DMARDs. At 24 weeks, MDA status, DAPSA remission, and ASDAS-CRP inactive disease were achieved in 47%, 23%, and 48% of patients, respectively. Minor, moderate, and major DAPSA improvement was observed in 67%, 39%, and 23%, respectively; while 65% and 35% achieved ASDAS-CRP CII and MI, respectively. The mean change from baseline was 15.9 ± 13.5 (p < 0.001) for DAPSA and 1.21 ± 0.97 (p < 0.001) for ASDAS-CRP. Thirteen patients (10%) discontinued UPA due to a lack of efficacy or non-serious adverse events. No serious adverse events were observed. Male gender (OR 2.54, 95% CI 1.03-6.25 p = 0.043), being naïve to biological DMARDs (OR 4.13, 95% CI 1.34-12.71, p = 0.013) and elevated baseline CRP (OR 2.49, 95% CI 1.02-6.12, p = 0.046) were associated with MDA response at week 24. CONCLUSIONS This is one of the first real-life studies supporting the effectiveness of UPA and its safety profile in PsA patients. Furthermore, the study identifies predictors of MDA response to UPA treatment at 6 months.
Collapse
Affiliation(s)
- Michele Maria Luchetti Gentiloni
- CLINICA MEDICA, Department of Molecular and Biological Sciences, Marche Polytechnic University, and Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy.
| | - Valentino Paci
- CLINICA MEDICA, Department of Molecular and Biological Sciences, Marche Polytechnic University, and Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
- Internal Medicine Residency Program, Marche Polytechnic University, Ancona, Italy
| | - Antonio Carletto
- Department of Medicine, Rheumatology Operative Unit, AOUI Verona, Verona, Italy
| | - Alen Zabotti
- Department of Medicine, Rheumatology Institute, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Roberta Ramonda
- Department of Medicine-DIMED, Rheumatology Unit, University of Padova, Padua, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, University of Rome "Tor Vergata", Rome, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicoletta Luciano
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Anna Piccinelli
- Department of Medicine, Rheumatology Operative Unit, AOUI Verona, Verona, Italy
| | - Ivan Giovannini
- Department of Medicine, Rheumatology Institute, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giovanni Striani
- Department of Medicine-DIMED, Rheumatology Unit, University of Padova, Padua, Italy
| | - Nicola Boffini
- Unit of Immunology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gilda Sandri
- Department of Maternal, Infantile and Adult Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Niccolò Possemato
- Rheumatology Unit, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Ilenia Pantano
- Department of Precision Medicine, Rheumatology Unit, University Della Campania L. Vanvitelli, Naples, Italy
| | - Devis Benfaremo
- CLINICA MEDICA, Department of Molecular and Biological Sciences, Marche Polytechnic University, and Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Carlo Salvarani
- Department of Maternal, Infantile and Adult Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Rheumatology Unit, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Ciccia
- Department of Precision Medicine, Rheumatology Unit, University Della Campania L. Vanvitelli, Naples, Italy
| | - Carlo Selmi
- Department of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Gianluca Moroncini
- CLINICA MEDICA, Department of Molecular and Biological Sciences, Marche Polytechnic University, and Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| |
Collapse
|
35
|
Yuan Z, Luo J, Cheng QF, Zhang Q. Clinical efficacy of ultrasound-guided stellate ganglion block combined with extracorporeal shock wave therapy on limb spasticity in patients with ischemic stroke. BMC Neurol 2023; 23:349. [PMID: 37794321 PMCID: PMC10548723 DOI: 10.1186/s12883-023-03391-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION To observe the clinical efficacy of ultrasound-guided stellate ganglion block (SGB) + extracorporeal shock wave therapy (ESWT) for limb spasticity in patients with ischemic stroke. METHODS A total of 60 patients with post-stroke limb spasticity in our hospital were selected and randomly divided into four groups (n = 15). In the control group, patients received routine rehabilitation training. Based on routine rehabilitation training, SGB group patients underwent ultrasound-guided SGB, ESWT group patients received ESWT, and SGB + ESWT group patients received ultrasound-guided SGB combined with ESWT. The total treatment course was one month. The Modified Barthel Index (MBI) score, Fugl-Meyer Assessment and upper limb rehabilitation training system were applied to evaluate the activities of daily living, upper limb motor function and upper limb performance before and after treatment. Finally, the improvement after treatment was compared among different groups. RESULTS After treatment, compared with the control group, the MBI score and the upper limb score based on Fugl-Meyer Assessment in the SGB, ESWT, and SGB + ESWT groups were significantly increased (P < 0.05). Furthermore, compared with the SGB and ESWT groups, SGB + ESWT exhibited a higher upper limb function score (P < 0.05), while the MBI score was not significantly different (P > 0.05). In terms of upper limb performance ability, patients in the SGB, ESWT and SGB + ESWT groups had better fitting degree, participation and exertion of exercise than those in the control group, and the SGB + ESWT group patients had the same movement trajectory as robots. CONCLUSION Ultrasound-guided SGB and ESWT can reduce the muscle tension of patients, alleviate spasticity, promote the motor function of the upper limb, and improve the working performance of patients. However, the effect of SGB combined with ESWT is better.
Collapse
Affiliation(s)
- Zhen Yuan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China
- Rehabilitation medicine and physiotherapy, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jun Luo
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China
| | - Qing-Feng Cheng
- Urology Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China
| | - Qiao Zhang
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.
| |
Collapse
|
36
|
Dai J, Lin S, Cui X, Xu Z, Zheng R, Wu D. The effects of ultrasound-guided QLB and TAPB combined with opioid-free anesthesia (OFA) on clinical efficacy of the patients undergoing abdominal surgery. Heliyon 2023; 9:e20878. [PMID: 37867884 PMCID: PMC10589855 DOI: 10.1016/j.heliyon.2023.e20878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 10/03/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Background Although opioids provide effective analgesia for abdominal surgery, they also present serious unwanted side effects. Ultrasound-guild quadratus lumborum block (QLB) and transversus abdominis plane block (TAPB) have been proven to offer long-lasting and efficient analgesia during abdominal surgery. However, the clinical efficacy of ultrasound-guided QLB and TAPB combined with opioid-free anesthesia (OFA) in abdominal surgery remains unclear. Objective This study aimed to investigate the impact of ultrasound-guided QLB and TAPB combined with opioid-free anesthesia (OFA) on the clinical efficacy of abdominal surgery. Methods A total of 122 patients scheduled for abdominal surgery at People's Hospital of Wanning between March 2021 and April 2022 were enrolled in this study. Participants were randomly divided into two groups: the experimental group (QLB/TAPB + OFA, 62 patients) and the control group (opioid anesthesia, 60 patients). The clinical efficacy of the QLB/TAPB combined with OFA technique was evaluated by analyzing patients' vital signs, postoperative consciousness recovery time, numeric rating scale (NRS) score, and immune function in both groups. Results We observed that systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in experimental group were significantly higher than those in control group after induction (p < 0.05). Heart rate (HR) in experimental group was significantly lower than in the control group at intraoperative 1h (p < 0.05). Additionally, bispectral index (BIS), state entropy (SE), and response entropy (RE) levels in the experimental group were significantly higher than those in the control group (p < 0.05). Furthermore, extubation and awakening time were significantly shorter in the experimental group compared to the control group (p < 0.05). The NRS scores in the experimental group were markedly lower than those in the control group. Moreover, IL-6 and CRP levels in the experimental group were obviously lower than in the control group after postoperative 1d (p < 0.05). Interestingly, IL-6 (p < 0.001), CRP (p < 0.001), and PCT (p = 0.037) levels in female patients of the experimental group were all significantly lower than those in the control group after postoperative 1d. Conclusions Ultrasound-guided QLB and TAPB combined with OFA technique can reduce pain intensity and enhance the patients' immune function in abdominal surgery.
Collapse
Affiliation(s)
- Jingwei Dai
- Department of Anesthesiology, People's Hospital of Wanning, Wanning, Hainan, China
| | - Shiwen Lin
- Department of Medical Laboratory, People's Hospital of Wanning, Wanning, Hainan, China
| | - Xiaoguang Cui
- Department of Anesthesiology, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Zhixin Xu
- Department of Anesthesiology, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Riyue Zheng
- Department of Anesthesiology, People's Hospital of Wanning, Wanning, Hainan, China
| | - Duozhi Wu
- Department of Anesthesiology, Hainan General Hospital, Haikou, Hainan, China
| |
Collapse
|
37
|
Chen H, Liu Y, Huang D, Zhang X, She L. Transoral robotic surgery vs. non-robotic surgeries for oropharyngeal squamous cell carcinoma: systematic review and meta-analysis. J Robot Surg 2023; 17:2537-2546. [PMID: 37542007 DOI: 10.1007/s11701-023-01689-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/30/2023] [Indexed: 08/06/2023]
Abstract
To compare the effectiveness of transoral robotic surgery (TORS) and non-robotic surgeries (NRES) in patients with oropharyngeal squamous cell carcinoma (OPSCC), medical databases were searched including PubMed, Web of Science, Medline, Embase, and Cochrane Library up to January 2023. The methodology follows PRISMA guidelines, including the PRISMA flow diagram. Data from the included studies were extracted independently by two researchers. Seven studies involving five hundred seventy-seven patients were included. Of these, 275 underwent TORS and 302 underwent NRES. The disease-free survival rate was significantly higher in the TORS group than in the NRES group (OR = 3.43, 95% CI 1.92-6.15, P < 0.0001). However, there were no significant differences in positive surgical margins, hospital stays, operation time, blood loss, postoperative bleeding rate, perioperative tracheostomy, perioperative feeding tube, and overall survival rate. These findings can initially guide the preoperative counseling of TORS in patients with OPSCC, and preliminarily confirm that the adoption of TORS deserves careful consideration.
Collapse
Affiliation(s)
- Huihong Chen
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
| | - Yong Liu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), 87 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Donghai Huang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
| | - Xin Zhang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), 87 Xiangya Road, Changsha, Hunan, People's Republic of China
| | - Li She
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People's Republic of China.
- Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, Hunan, People's Republic of China.
- Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, Hunan, People's Republic of China.
| |
Collapse
|
38
|
Chen Y, Liu J, Zhang J, Yang L, Jin L. Research progress in the quality evaluation of Salvia miltiorrhiza based on the association of 'morphological features - functional substances - pharmacological action - clinical efficacy'. Heliyon 2023; 9:e20325. [PMID: 37780757 PMCID: PMC10539976 DOI: 10.1016/j.heliyon.2023.e20325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Background Salvia miltiorrhiza (Salvia miltiorrhiza Radix et Rhizoma) is the dried root and rhizome of Salvia miltiorrhiza Bge., a plant of the labiate family. It is a type of traditional Chinese medicine that can promote blood circulation for removing blood stasis. It is often used to treat cardiovascular and cerebrovascular diseases in a clinic.Aim of the study: High-quality Chinese herbal medicines are the premise of the safe and effective use of Traditional Chinese Medicine (TCM) in clinics. We aim to prove the rationality of the traditional identification method, namely, 'the redder the root colour and the thicker the root, the better is the quality', to use the morphological features of Salvia miltiorrhiza as the main index to quickly and directly evaluate its quality. Materials and methods By referring to relevant ancient books, domestic and foreign literature, and academic papers, we summarised the research progress regarding the morphological features, functional substances, pharmacological action, and clinical efficacy of Salvia miltiorrhiza. Results The redder the colour, the thicker the root, and the denser the texture, the better is the quality of Salvia miltiorrhiza. In Salvia miltiorrhiza, tanshinone ⅡA and salvianolic acid B are the main functional substances that protect the cardiovascular and cerebrovascular functions. The higher the content of these two functional substances, the better is the clinical efficacy of Salvia miltiorrhiza. Conclusion The research idea of the correlation between the 'morphological features, functional substances, pharmacological action, and clinical efficacy' can be applied to evaluate the quality of Salvia miltiorrhiza. This research idea and method can also be applied to more Chinese herbal medicines.
Collapse
Affiliation(s)
- Yiyang Chen
- Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu Province, China
| | - Juanjuan Liu
- Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu Province, China
| | - Jialing Zhang
- Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu Province, China
| | - Liping Yang
- Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu Province, China
| | - Ling Jin
- Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu Province, China
- Northwest Collaborative Innovation Center for Traditional Chinese Medicine Co-constructed By Gansu Province & MOE of PR China, Lanzhou, Gansu Province, China
- Engineering Research Center for Evaluation, Protection, And Utilization of Rare Traditional Chinese Medicine Resources, Lanzhou, Gansu Province, China
- Gansu Provincial Innovation Research Institute of Chinese Medicinal Materials Industry, Lanzhou, Gansu Province, China
| |
Collapse
|
39
|
Shu X, Zhao S, Huo W, Tang Y, Zou L, Li Z, Li L, Wang X. Clinical study of a spray containing birch juice for repairing sensitive skin. Arch Dermatol Res 2023; 315:2271-2281. [PMID: 36961534 PMCID: PMC10462575 DOI: 10.1007/s00403-023-02588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/14/2022] [Accepted: 02/16/2023] [Indexed: 03/25/2023]
Abstract
Sensitive skin is described as an unpleasant sensory response to a stimulus that should not cause a sensation. Sensitive skin affects an increasing proportion of the population. Sixty-seven participants who tested positive to lactic acid sting test were recruited and randomized into two groups to observe the clinical efficacy and safety of a new birch juice spray for repairing sensitive skin. One group used test spray A, while the other group used spray B as a control. Both groups were sprayed six times daily for 28 days. Noninvasive testing instruments were used to measure stratum corneum hydration, sebum content, transepidermal water loss rates, skin blood perfusion and current perception threshold before and after using spray. Facial images were captured by VISIA-CR, and the image analysis program (Image-Pro Plus) was used to analyze these to obtain the redness value of the facial skin. Moreover, lactic acid sting test scores and participants' self-assessments were also performed at baseline, week 2 and week 4. Both sprays A and B significantly decreased the lactic acid sting test score, transepidermal water loss rates, skin blood perfusion, and redness, while increasing the stratum corneum hydration. Compared to spray B, spray A increased sensory nerve thresholds at 5 Hz and decreased the transepidermal water loss rates, skin blood perfusion, and lactic acid sting test score. Sprays containing birch juice improved cutaneous biophysical properties in participants with sensitive skin.
Collapse
Affiliation(s)
- Xiaohong Shu
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Shizhi Zhao
- Yoseido (Shanghai) Cosmetics R&D Co., Ltd., Shanghai, People's Republic of China
| | - Wei Huo
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Ying Tang
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Lin Zou
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Zhaoxia Li
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Li Li
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Department of Dermatology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xi Wang
- Cosmetics Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
- Department of Dermatology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
| |
Collapse
|
40
|
Yves H, Herman J, Uebelhoer M, Wauquier F, Boutin-Wittrant L, Donneau AF, Monseur J, Fotso VM, Duquenne M, Wagner M, Bouvret E, Costes B, Wittrant Y. Oral supplementation with fish cartilage hydrolysate in an adult population suffering from knee pain and function discomfort: results from an innovative approach combining an exploratory clinical study and an ex vivo clinical investigation. BMC Musculoskelet Disord 2023; 24:748. [PMID: 37735385 PMCID: PMC10512646 DOI: 10.1186/s12891-023-06800-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/16/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Aging is frequently associated with impairments of the musculoskeletal system and many elderly people experience joint discomfort or pain which might reduce their ability to move and consequently alter their quality of life. A beneficial effect of fish cartilage hydrolysate (FCH) on pain and joint function has recently been shown in an ACLT/pMMx osteoarthritis rat model. METHODS We therefore performed an exploratory, non-comparative, multi-centric clinical trial including 33 subjects with moderate knee joint discomfort and loss of functionality to investigate the efficacy of FCH on their algo-functional status. We further determined the potential health benefit of FCH in an original clinical ex vivo study investigating the role of FCH human metabolites on primary human chondrocytes. RESULTS FCH significantly improved knee pain and function, as assessed by the Knee injury and Osteoarthritis Outcome Score (KOOS). Moreover, FCH significantly reduced pain at rest and while walking, and patient global assessment (PGA), as assessed by the Visual Analogue Scale (VAS), and improved patients' quality of life (SF-36). FCH metabolites decreased the synthesis of catabolic factors (MMP-13) and pro-inflammatory mediators (NO, PGE2) and limited the inhibitory effect of IL-1β on the synthesis of cartilage matrix components (GAG and collagen). CONCLUSIONS Thus, these data provide insights on the mode of action of FCH in humans and contribute to explain how FCH may relieve pain and improve joint function in subjects with knee discomfort. Although these preliminary data need to be confirmed in a randomized controlled trial, they strongly support the potential health benefit of such an active ingredient. TRIAL REGISTRATION The study was registered on clinicaltrials.gov with the identifier NCT04420091 (09/06/2020).
Collapse
Affiliation(s)
- Henrotin Yves
- Service de Kinésithérapie et de Réadaptation Fonctionnelle, Hôpital Princesse Paola, Vivalia, Rue du Vivier 21, Marche-en-Famenne, 6900, Belgium.
- musculoSKeletal Innovative research Lab (mSKIL), University of Liège, Liège, 4000, Belgium.
| | - Julie Herman
- Artialis SA, Avenue de l'Hôpital 11, Liège, 4000, Belgium
| | | | - Fabien Wauquier
- Clinic'n'Cell SAS, UFR de Médecine et de Pharmacie, 28 Place Henri Dunant, Clermont-Ferrand, TSA, 50400 63001, France
| | - Line Boutin-Wittrant
- Clinic'n'Cell SAS, UFR de Médecine et de Pharmacie, 28 Place Henri Dunant, Clermont-Ferrand, TSA, 50400 63001, France
| | - Anne-Françoise Donneau
- Département des Sciences de la Santé publique, UR BSTAT ULiège, Université de Liège, Avenue Hippocrate 13, Liège, 4000, Belgium
| | - Justine Monseur
- Département des Sciences de la Santé publique, UR BSTAT ULiège, Université de Liège, Avenue Hippocrate 13, Liège, 4000, Belgium
| | | | - Marie Duquenne
- musculoSKeletal Innovative research Lab (mSKIL), University of Liège, Liège, 4000, Belgium
| | - Mélanie Wagner
- Centre Médical Chant d'oiseau, Avenue des Frères Legrain 85, Woluwe-Saint Pierre, 1150, Belgium
| | - Elodie Bouvret
- Abyss Ingredients, 860 Route de Caudan, Caudan, 56850, France
| | | | - Yohann Wittrant
- INRAE, UNH, Clermont-Ferrand, 63001, France
- Université Clermont Auvergne, UFR de Médecine de de Pharmacie, 28 Place Henri Dunant, Clermont-Ferrand, TSA, 50400 63001, France
| |
Collapse
|
41
|
Cheon JH, Kim HS, Han DS, Kim SK, Shin SJ, Kim JS, Ye BD, Song GA, Lee Y, Kim Y, Lee Y, Kim WH. Efficacy and Safety of Infliximab in Intestinal Behçet's Disease: A Multicenter, Phase 3 Study (BEGIN). Gut Liver 2023; 17:777-785. [PMID: 36578194 PMCID: PMC10502498 DOI: 10.5009/gnl220278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 12/30/2022] Open
Abstract
Background/Aims To date, there is no prospective study that specifically investigated the efficacy of infliximab in intestinal Behçet's disease (BD). This study evaluated the efficacy of infliximab in patients with moderate-to-severe active intestinal BD that are refractory to conventional therapies. Methods This phase 3, interventional, open-label, single-arm study evaluated clinical outcomes of infliximab treatment in patients with moderate-to-severe intestinal BD. The coprimary endpoints were clinical response, decrease in disease activity index for intestinal BD (DAIBD) score ≥20 from weeks 0 to 8 for the induction therapy and week 32 for the maintenance therapy. Results A total of 33 patients entered the induction therapy and were treated with infliximab 5 mg/kg intravenously at weeks 0, 2, and 6. The mean DAIBD score changed from 90.8±40.1 at week 0 to 40.3±36.4 at week 8, with a significant mean change of 50.5±36.4 (95% confidence interval, 37.5 to 63.4; p<0.001). Thirty-one (93.9%) continued to receive 5 mg/kg infliximab every 8 weeks during the maintenance therapy. The mean change in the DAIBD score after the maintenance therapy was statistically significant (61.5±38.5; 95% confidence interval, 46.0 to 77.1; p<0.001, from weeks 0 to 32). The proportion of patients who maintained a clinical response was 92.3% at week 32. No severe adverse reactions occurred during the induction and maintenance therapies. Conclusions This study provided evidence that infliximab 5 mg/kg induction and maintenance therapies are efficacious and well-tolerated in patients with moderate-to-severe active intestinal BD. (ClinicalTrials.gov identifier: NCT02505568).
Collapse
Affiliation(s)
- Jae Hee Cheon
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong Soo Han
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Sung Kook Kim
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Jae Shin
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Joo Sung Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byong Duk Ye
- Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea
| | - Geun Am Song
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - YoungJa Lee
- Medical Affairs, Janssen Korea, Seoul, Korea
| | | | - Yoosun Lee
- Medical Affairs, Janssen Korea, Seoul, Korea
| | - Won Ho Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | | |
Collapse
|
42
|
Beymouri A, Yaghobee S, Khorsand A, Safi Y. Comparison of morbidity at the donor site and clinical efficacy at the recipient site between two different connective tissue graft harvesting techniques from the palate: A randomized clinical trial. J Adv Periodontol Implant Dent 2023; 15:108-116. [PMID: 38357340 PMCID: PMC10862051 DOI: 10.34172/japid.2023.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/26/2023] [Indexed: 02/16/2024]
Abstract
Background This study was conducted to compare the pain levels in patients and the clinical efficacy of grafts obtained using two techniques, namely de-epithelialized gingival graft (DGG) and subepithelial connective tissue graft (SCTG), in combination with coronally advanced flap (CAF) for the treatment of multiple adjacent gingival recessions. Methods Twelve patients were treated using DGG+CAF on one side and SCTG+CAF on the other. The patients' pain levels at the surgical site, the number of analgesics taken on days 3 and 7, the mean root coverage (MRC), the percentage of complete root coverage (CRC), color match, and gingival thickness (GT) at the graft recipient site were evaluated 6 months after surgery. Results The total number of analgesics taken during the 7-day period after surgery and pain levels at the surgical site from day 3 to day 7 were significantly higher in the DGG+CAF group compared to the SCTG+CAF group (P=0.001). In the 6-month follow-up, color match and CRC were significantly higher in the SCTG+CAF group, while GT was significantly higher in the DGG+CAF group. There was no significant difference in MRC between the two groups. Conclusion The pain and analgesic consumption levels were higher in the DGG+CAF group compared to the SCTG+CAF group, and the recipient site had a weaker color match. However, this technique can lead to a greater increase in the thickness of the grafted area.
Collapse
Affiliation(s)
- Amine Beymouri
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Yaghobee
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Khorsand
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
43
|
Liu X, Li H, Wang F, Su K, He B, He J, Zhong J, Han Y, Li Z. Transhepatectomy combined with arterial chemoembolization and transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a clinical prognostic analysis. BMC Gastroenterol 2023; 23:299. [PMID: 37670232 PMCID: PMC10478419 DOI: 10.1186/s12876-023-02886-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/13/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The prognosis of patients undergoing hepatectomy combined with transarterial chemoembolization (TACE) and TACE alone was examined in order to better understand the role of hepatectomy in the treatment of hepatocellular carcinoma (HCC). In this work, we also created a model and investigated the variables influencing overall survival (OS) in HCC patients. METHODS Retrospective analysis of 1083 patients who received TACE alone as the control group and 188 patients who received TACE after surgery in a total of 1271 HCC patients treated with LR + TACE or TACE at three third-class hospitals in China. It was done using the Propensity Score Matching (PSM) technique. The differences in OS between the two groups were compared, and OS-influencing factors were looked at. The main endpoint is overall survival. In this study, the COX regression model was used to establish the nomogram. RESULTS The median OS of the LR + TACE group was not attained after PSM. The median OS for the TACE group was 28.8 months (95% CI: 18.9-38.7). The median OS of the LR + TACE group was higher than that of the TACE group alone, indicating a significant difference between the two groups (χ2 = 16.75, P < 0.001). While it was not achieved in the LR + TACE group, the median OS for patients with lymph node metastases in the TACE group alone was 18.8 months. The two groups differed significantly from one another (χ2 = 4.105, P = 0.043). In patients with distant metastases, the median OS of the LR + TACE treatment group was not achieved, and the median OS of the TACE group alone was 12.0 months. The difference between the two groups was sizable (χ2 = 5.266, P = 0.022). The median OS for patients with PVTT following PSM was 30.1 months in the LR + TACE treatment group and 18.7 months in the TACE alone group, respectively. The two groups differed significantly from one another (χ2 = 5.178, P = 0.023); There was no discernible difference between the two groups in terms of median overall survival (OS), which was 30.1 months for patients with lymph node metastasis and 19.2 months for those without (P > 0.05); Regarding the median OS for patients with distant metastases, which was not achieved and 8.5 months, respectively, there was a significant difference between the two groups (χ2 = 5.759, P = 0.016). We created a new nomogram to predict 1-, 2-, and 3-year survival rates based on multiple independent predictors in COX multivariate analysis. The cohort's C-index is 0.705. The area under the curve (AUC value) for predicting 1-, 2-, and 3-year survival rates were shown by the subject operating characteristic (ROC) curve linked to the nomogram to be 0.730, 0.728, and 0.691, respectively. CONCLUSIONS LR + TACE can increase OS, delay tumor recurrence, and improve prognosis in HCC patients when compared to TACE alone. Additionally, the nomogram we created does a good job of forecasting the 1-year survival rate of hepatocellular carcinoma.
Collapse
Affiliation(s)
- Xin Liu
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Department of Radiophysics and Technology, Shandong First Medical University (Shandong Academy of Medical Sciences), Shandong Institute of Cancer Prevention and Treatment (Shandong Cancer Hospital), Jinan, China
| | - Haodong Li
- Department of Radiophysics and Technology, Shandong First Medical University (Shandong Academy of Medical Sciences), Shandong Institute of Cancer Prevention and Treatment (Shandong Cancer Hospital), Jinan, China
- Graduate Department of Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, China
| | - Fei Wang
- Department of General Surgery, Luxian People's Hospital, Luzhou, China
| | - Ke Su
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Bingsheng He
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Shandong Institute of Cancer Prevention and Treatment (Shandong Cancer Hospital), Department of Radiotherapy, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, China
| | - Jie He
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Shandong Institute of Cancer Prevention and Treatment (Shandong Cancer Hospital), Department of Radiotherapy, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, China
| | - Jiaqi Zhong
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China
- Shandong Institute of Cancer Prevention and Treatment (Shandong Cancer Hospital), Department of Radiotherapy, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, China
| | - Yunwei Han
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
| | - Zhenjiang Li
- Department of Radiophysics and Technology, Shandong First Medical University (Shandong Academy of Medical Sciences), Shandong Institute of Cancer Prevention and Treatment (Shandong Cancer Hospital), Jinan, China.
| |
Collapse
|
44
|
Shim SS, Berglund K, Yu SP. Lithium: An Old Drug for New Therapeutic Strategy for Alzheimer's Disease and Related Dementia. NEURODEGENER DIS 2023; 23:1-12. [PMID: 37666228 DOI: 10.1159/000533797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Although Alzheimer's disease (AD) is the most common form of dementia, the effective treatment of AD is not available currently. Multiple trials of drugs, which were developed based on the amyloid hypothesis of AD, have not been highly successful to improve cognitive and other symptoms in AD patients, suggesting that it is necessary to explore additional and alternative approaches for the disease-modifying treatment of AD. The diverse lines of evidence have revealed that lithium reduces amyloid and tau pathology, attenuates neuronal loss, enhances synaptic plasticity, and improves cognitive function. Clinical studies have shown that lithium reduces the risk of AD and deters the progress of mild cognitive impairment and early AD. SUMMARY Our recent study has revealed that lithium stabilizes disruptive calcium homeostasis, and subsequently, attenuates the downstream neuropathogenic processes of AD. Through these therapeutic actions, lithium produces therapeutic effects on AD with potential to modify the disease process. This review critically analyzed the preclinical and clinical studies for the therapeutic effects of lithium on AD. We suggest that disruptive calcium homeostasis is likely to be the early neuropathological mechanism of AD, and the stabilization of disruptive calcium homeostasis by lithium would be associated with its therapeutic effects on neuropathology and cognitive deficits in AD. KEY MESSAGES Lithium is likely to be efficacious for AD as a disease-modifying drug by acting on multiple neuropathological targets including disruptive calcium homeostasis.
Collapse
Affiliation(s)
- Seong Sool Shim
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Mental Health Service Line, Department of Veteran's Affair, Atlanta VA Medical Center, Decatur, Georgia, USA
- Department of Veteran's Affair, Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, USA
| | - Ken Berglund
- Department of Veteran's Affair, Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, USA
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Shan Ping Yu
- Department of Veteran's Affair, Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, USA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA
| |
Collapse
|
45
|
Xu B, Zeng F, Deng J, Yao L, Liu S, Hou H, Huang Y, Zhu H, Wu S, Li Q, Zhan W, Qiu H, Wang H, Li Y, Yang X, Cao Z, Zhang Y, Zhou H. A homologous and molecular dual-targeted biomimetic nanocarrier for EGFR-related non-small cell lung cancer therapy. Bioact Mater 2023; 27:337-347. [PMID: 37122898 PMCID: PMC10140750 DOI: 10.1016/j.bioactmat.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
The abnormal activation of epidermal growth factor receptor (EGFR) drives the development of non-small cell lung cancer (NSCLC). The EGFR-targeting tyrosine kinase inhibitor osimertinib is frequently used to clinically treat NSCLC and exhibits marked efficacy in patients with NSCLC who have an EGFR mutation. However, free osimertinib administration exhibits an inadequate response in vivo, with only ∼3% patients demonstrating a complete clinical response. Consequently, we designed a biomimetic nanoparticle (CMNP@Osi) comprising a polymeric nanoparticle core and tumor cell-derived membrane-coated shell that combines membrane-mediated homologous and molecular targeting for targeted drug delivery, thereby supporting a dual-target strategy for enhancing osimertinib efficacy. After intravenous injection, CMNP@Osi accumulates at tumor sites and displays enhanced uptake into cancer cells based on homologous targeting. Osimertinib is subsequently released into the cytoplasm, where it suppresses the phosphorylation of upstream EGFR and the downstream AKT signaling pathway and inhibits the proliferation of NSCLC cells. Thus, this dual-targeting strategy using a biomimetic nanocarrier can enhance molecular-targeted drug delivery and improve clinical efficacy.
Collapse
Affiliation(s)
- Bin Xu
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, 511442, PR China
| | - Fanjun Zeng
- Department of General Practice, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
| | - Jialong Deng
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, PR China
| | - Lintong Yao
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- Shantou University Medical College, Shantou, 515063, PR China
| | - Shengbo Liu
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, PR China
| | - Hengliang Hou
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, PR China
| | - Yucheng Huang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- School of Medicine, South China University of Technology, Guangzhou, 510006, PR China
| | - Hongyuan Zhu
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
| | - Shaowei Wu
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, PR China
| | - Qiaxuan Li
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- Shantou University Medical College, Shantou, 515063, PR China
| | - Weijie Zhan
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, PR China
| | - Hongrui Qiu
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Huili Wang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
| | - Yundong Li
- South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Key Laboratory of South China Sea Fishery Resources Exploitation and Utilization, Ministry of Agriculture and Rural Affairs, Guangzhou, 510300, China
| | - Xianzhu Yang
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, 511442, PR China
| | - Ziyang Cao
- Guangzhou First People's Hospital, South China University of Technology, Guangzhou, 510006, PR China
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou International Campus, Guangzhou, 511442, PR China
- Corresponding author. Guangzhou First People's Hospital, South China University of Technology, Guangzhou, 510006, PR China.
| | - Yu Zhang
- Department of Orthopedics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, Guangdong, China
- Corresponding author.
| | - Haiyu Zhou
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, PR China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, PR China
- Shantou University Medical College, Shantou, 515063, PR China
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, PR China
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, PR China
- School of Medicine, South China University of Technology, Guangzhou, 510006, PR China
- Corresponding author. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, PR China.
| |
Collapse
|
46
|
Meng T, Ding J, Shen S, Xu Y, Wang P, Song X, Li Y, Li S, Xu M, Tian Z, He Q. Xuanfei Baidu decoction in the treatment of coronavirus disease 2019 (COVID-19): Efficacy and potential mechanisms. Heliyon 2023; 9:e19163. [PMID: 37809901 PMCID: PMC10558324 DOI: 10.1016/j.heliyon.2023.e19163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 10/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide and become a major global public health concern. Although novel investigational COVID-19 antiviral candidates such as the Pfizer agent PAXLOVID™, molnupiravir, baricitinib, remdesivir, and favipiravir are currently used to treat patients with COVID-19, there is still a critical need for the development of additional treatments, as the recommended therapeutic options are frequently ineffective against SARS-CoV-2. The efficacy and safety of vaccines remain uncertain, particularly with the emergence of several variants. All 10 versions of the National Health Commission's diagnosis and treatment guidelines for COVID-19 recommend using traditional Chinese medicine. Xuanfei Baidu Decoction (XFBD) is one of the "three Chinese medicines and three Chinese prescriptions" recommended for COVID-19. This review summarizes the clinical evidence and potential mechanisms of action of XFBD for COVID-19 treatment. With XFBD, patients with COVID-19 experience improved clinical symptoms, shorter hospital stay, prevention of the progression of their symptoms from mild to moderate and severe symptoms, and reduced mortality in critically ill patients. The mechanisms of action may be associated with its direct antiviral, anti-inflammatory, immunomodulatory, antioxidative, and antimicrobial properties. High-quality clinical and experimental studies are needed to further explore the clinical efficacy and underlying mechanisms of XFBD in COVID-19 treatment.
Collapse
Affiliation(s)
- Tiantian Meng
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100032, China
- Department of Rehabilitation, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100071, China
| | - Jingyi Ding
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100032, China
| | - Shujie Shen
- State Key Laboratory of Natural and Biomimetic Drugs, Peking University, Beijing, 100089, China
| | - Yingzhi Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100010 China
| | - Peng Wang
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100010, China
- Department of Traditional Chinese Medicine, Beijing Jiangong Hospital, Beijing, 100032, China
| | - Xinbin Song
- Graduate School, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Yixiang Li
- Graduate School, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Shangjin Li
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100032, China
| | - Minjie Xu
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100010 China
| | - Ziyu Tian
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Qingyong He
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100032, China
| |
Collapse
|
47
|
Wu L, Yuan Q, Wu L, Hua-Xiang Xia H, Zhong M, Liu T, Ye X, Luo D, Xu J, Xie W, He X, Cai J. Efficacy of washed microbiota transplantation for therapeutic targets of refractory functional constipation and the influencing factors: a single-center, retrospective, 24-week follow-up study. BMC Gastroenterol 2023; 23:291. [PMID: 37641043 PMCID: PMC10463406 DOI: 10.1186/s12876-023-02929-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/19/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The efficacy of washed microbiota transplantation (WMT) in terms of refractory functional constipation (FC)-related therapeutic targets and influencing factors have not been elucidated. This study aimed to assess the efficacy and influencing factors of WMT in treating refractory FC-related therapeutic targets. METHODS The clinical data of patients diagnosed with refractory FC and received with WMT were retrospectively collected. The therapeutic targets included straining, hard stools, incomplete evacuation, a sense of anorectal obstruction, manual maneuvers, and decreased stool frequency. Each target was recorded as 1 (yes) or 0 (no). All patients were followed up for approximately 24 weeks from the end of the first course of WMT. The primary outcomes were the improvement rates for the individual therapeutic targets and the overall response in respect of the therapeutic targets decreased by 2 at weeks 4, 8, and 24. The secondary outcomes were the clinical remission rate (i.e., the proportion of patients with an average of 3 or more spontaneous complete bowel movements per week), clinical improvement rate (i.e., the proportion of patients with an average increase of 1 or more SCBMs/week or patients with remission), stool frequency, Wexner constipation score, Bristol Stool Form Scale (BSFS) score, and adverse events. The factors influencing the efficacy were also analyzed. RESULTS Overall, 63 patients with 112 WMT courses were enrolled. The improvement rates at weeks 8 and 24 were 45.6% and 35.0%, 42.9% and 38.6%, 45.0% and 35.7%, 55.6% and 44.4%, and 60.9% and 50.0%, respectively, for straining, hard stools, incomplete evacuation, a sense of anorectal obstruction, and decreased stool frequency. The overall response rates were 49.2%, 50.8%, and 42.9%, respectively, at weeks 4, 8, and 24. The rates of clinical remission and clinical improvement were 54.0% and 68.3%, respectively, at weeks 4. The stool frequency, BSFS score, and Wexner constipation score tended to improve post-WMT. Only 22 mild adverse events were observed during the 112 WMT courses and the follow-up. The number of WMT courses was identified to be the independent factor influencing the efficacy. CONCLUSIONS WMT is efficacious in improving refractory FC-related therapeutic targets. The effectiveness of WMT in the management of FC is enhanced with the administration of multiple courses.
Collapse
Affiliation(s)
- Liquan Wu
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Qingfen Yuan
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Lihao Wu
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Harry Hua-Xiang Xia
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Muxiao Zhong
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Tao Liu
- Department of Medical Record, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, China
| | - Xiaoyan Ye
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Danping Luo
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Jiating Xu
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Wenrui Xie
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Xingxiang He
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China
| | - Jieyi Cai
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, 510080, China.
| |
Collapse
|
48
|
Qi RZ, Li ZW, Chang ZY, Chang WH, Zhao WL, Pang C, Zhang Y, Hu XL, Liang F. Clinical efficacy of total laparoscopic splenectomy for portal hypertension and its influence on hepatic hemodynamics and liver function. World J Gastrointest Surg 2023; 15:1684-1692. [PMID: 37701706 PMCID: PMC10494577 DOI: 10.4240/wjgs.v15.i8.1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/16/2023] [Accepted: 06/06/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The liver hemodynamic changes caused by portal hypertension (PH) are closely related to various complications such as gastroesophageal varices and portosys-temic shunts, which may lead to adverse clinical outcomes in these patients, so it is of great clinical significance to find treatment strategies with favorable clinical efficacy and low risk of complications. AIM To study the clinical efficacy of total laparoscopic splenectomy (TLS) for PH and its influence on hepatic hemodynamics and liver function. METHODS Among the 199 PH patients selected from October 2016 to October 2020, 100 patients [observation group (OG)] were treated with TLS, while the remaining 99 [reference group (RG)] were treated with open splenectomy (OS). We observed and compared the clinical efficacy, operation indexes [operative time (OT) and intraoperative bleeding volume], safety (intraperitoneal hemorrhage, ascitic fluid infection, eating disorders, liver insufficiency, and perioperative death), hepatic hemodynamics (diameter, velocity, and flow volume of the portal vein system), and liver function [serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), and serum total bilirubin (TBil)] of the two groups. RESULTS The OT was significantly longer and intraoperative bleeding volume was significantly lesser in the OG than in the RG. Additionally, the overall response rate, postoperative complications rate, and liver function indexes (ALT, AST, and TBil) did not differ significantly between the OG and RG. The hepatic hemodynamics statistics showed that the pre- and postoperative blood vessel diameters in the two cohorts did not differ statistically. Although the postoperative blood velocity and flow volume reduced significantly when compared with the preoperative values, there were no significant inter-group differences. CONCLUSION TLS contributes to comparable clinical efficacy, safety, hepatic hemodynamics, and liver function as those of OS in treating PH, with a longer OT but lesser intraoperative blood loss.
Collapse
Affiliation(s)
- Rui-Zhao Qi
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Zhi-Wei Li
- Department of Hepatobiliary, The 3rd People’s Hospital of Shenzhen, Shenzhen 518112, Guangdong Province, China
| | - Zheng-Yao Chang
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Wei-Hua Chang
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Wen-Lei Zhao
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Chuan Pang
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Ying Zhang
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Xing-Long Hu
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Feng Liang
- Department of General Surgery, 5th Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| |
Collapse
|
49
|
Cao S, Fan B, Song X, Wang Y, Yin W. Oblique lateral interbody fusion (OLIF) compared with unilateral biportal endoscopic lumbar interbody fusion (ULIF) for degenerative lumbar spondylolisthesis: a 2-year follow-up study. J Orthop Surg Res 2023; 18:621. [PMID: 37620977 PMCID: PMC10463437 DOI: 10.1186/s13018-023-04111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Oblique lumbar interbody fusion (OLIF) has been proven to be an effective method of indirect decompression for the treatment of Degenerative Lumbar Spondylolisthesis (DLS). However, its superiority over Unilateral biportal endoscopic Lumbar Interbody Fusion (ULIF) has not been reported yet. The current study aimed to compare the clinical and radiological outcomes of OLIF and ULIF in patients with DLS. METHODS A total of 107 patients were included in this study, divided into two groups according to the surgical methods with 45 patients treated by OLIF combined with anterolateral single screwrod fixation, and 62 patients treated by ULIF. To compare the perioperative parameters (blood loss, operation time, and postop hospitalization) and clinical (the Visual Analog Scale (VAS) scores of the low back pain and leg pain and the Oswestry Disability Index (ODI)) and radiological (disk height (DH), lumbar lordosis (LL), segmental lordosis (SL), the cross-sectional area (CSA) of the spinal canal) results of the two surgical approaches to evaluate their efficacy. RESULTS Compared with the ULIF group, the blood loss and operation time in the OLIF-AF group were significantly reduced, and the Postop hospitalization was comparable. The VAS scores in both groups were significantly improved compared to preop; however, the VAS score of low back pain in the OLIF-AF group was superior to that in ULIF group throughout the follow-up period (P < 0.05). The improvements in DH, LL, and Segmental angle were significantly lower in the ULIF group, and the expansion rate of CSA in the OLIF-AF group was superior to that in the ULIF group, but the difference was not statistically significant. The fusion rate in OLIF-AF group was significantly higher than that in ULIF group within 6 mo postop, and there was no significant difference at the last follow-up. The incidence of complications was comparable between the two groups, and there was no statistical difference. CONCLUSIONS Both OLIF-AF and ULIF achieved good short-term results in the treatment of DLS, and both surgical approaches are desirable. However, OLIF-AF has advantages over ULIF in terms of postoperative restoration of lumbar sagittal parameters and earlier intervertebral fusion. Long-term follow-up and larger clinical studies are needed to confirm this result.
Collapse
Affiliation(s)
- Shuyan Cao
- Department of Orthopaedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Bingjie Fan
- Department of Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xin Song
- Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Wang
- Department of Orthopaedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Wenzhe Yin
- Department of Orthopaedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
| |
Collapse
|
50
|
Li S, Xiao Z, Wang D, Yang K, Cao X, Wang G, Guo Z, Tong J, Fei W, Gong Y, Zhang Z. Clinical efficacy of LED golden light combined with acyclovir in the treatment of herpes zoster: a single-center prospective study. Lasers Med Sci 2023; 38:157. [PMID: 37407742 DOI: 10.1007/s10103-023-03817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
This study aimed to explore the safety and clinical efficacy of light emitting diode (LED) golden light combined with acyclovir in treating herpes zoster (HZ). According to the random number table, 54 inpatients with HZ were divided into control group, golden-light group, and red-light group, with 18 cases in each group. The control group received acyclovir intravenous drip, while the patients in the red-light group received acyclovir intravenous drip and red-light LED phototherapy, and the golden-light group received acyclovir intravenous drip and golden-light LED phototherapy. Primary assessments included herpes stopping time, incrustation time, decrustation time, pain visual analog scale scores (VAS), and incidence of postherpetic neuralgia (PHN) on the 30th and 90th days. Golden-light group and red-light group showed a shorter herpes stopping time, incrustation time, and decrustation time (P < 0.05) compared to the control group (P < 0.05), while the golden-light group showed a shorter incrustation time and decrustation time than the red light group (all P < 0.05). After treatment VAS scores, the golden-light group showed a significant improvement compared to the control group. The golden-light group showed a better PHN incidence than the control group at 30 days follow-up. Compared with the comprehensive curative effect, the total effective rates of the golden-light group, red-light group, and control group were 88.89%, 77.78%, and 72.22%, respectively, and the efficacy of the golden-light group was better than that of the control group and red-light group. Golden light combined with acyclovir can shorten the course of HZ, relieve pain, and reduce the occurrence of PHN, and the effect is better than that of the red-light group and the control group.
Collapse
Affiliation(s)
- Shiyang Li
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zixuan Xiao
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Duyang Wang
- Nanchang University National Institute of LED On Silicon Substrute, Nanchang, Jiangxi, China
| | - Kainan Yang
- Nanchang University National Institute of LED On Silicon Substrute, Nanchang, Jiangxi, China
| | - Xianwei Cao
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Guangxu Wang
- Nanchang University National Institute of LED On Silicon Substrute, Nanchang, Jiangxi, China.
| | - Zhuxiu Guo
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jianbo Tong
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wenmin Fei
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yangyang Gong
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhibin Zhang
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| |
Collapse
|