Evaluation of Clinical Efficacy of Combination of Surgery and Rehabilitation for Treatment of Scar Contracture after Hand Burn

Objective:To evaluate the clinical efficacy of combination of surgery and rehabilitation for patients with scar contracture after hand burn.Methods:Subjects of data calculation in this study were 66 patients with scar contracture after hand burn who were admitted from May 2018 to May 2019.The subjects were divided into regular group and combined group according to random number table method.The regular group(n=33)received surgical treatment alone.The combined group(n=33)patients were given surgery combined with rehabilitation.Recovery of hand function,efficacy of clinical treatment,hand function recovery and ADL score were calculated and compared between the two groups of patients with scare contracture after hand burn.Results:Efficacy,recovery of hand function(finger,finger flexion and extension,palm and finger adduction or abduction,daily activity,wrist rotation,wrist flexion and extension,appearance and sensory function)and ADL score were more superior in combined group when compared with regular group patients with scar contracture after hand burn.P<0.05,the indicator data showed statistical significance.Conclusion:Surgery combined with rehabilitation therapy shown significant value for patients with scar contracture after hand burn.

Evaluation of the relationship between hepatocellular carcinoma location and transarterial chemoembolization efficacy

AIM To evaluate the relationship between the location of hepatocellular carcinoma(HCC) and the efficacy of transarterial chemoembolization(TACE).METHODS We evaluated 115 patients(127 nodules), excluding recurrent nodules, treated with TACE between January 2011 and June 2014. TACE efficacy was evaluated according to m RECIST. The HCC location coefficient was calculated as the distance from the central portal portion to the HCC center(mm)/liver diameter(mm) on multiplanar reconstruction images rendered(MPR) to visualize bifurcation of the right and left branches of the portal vein and HCC center. The HCC location coefficient was compared between complete response(CR) and non-CR groups in Child-Pugh grade A and B patients.RESULTS The median location coefficient of HCC among all nodules, the right lobe, and the medial segment was significantly higher in the CR group than in the non-CR group in the Child-Pugh grade A patients(0.82 vs 0.62, P < 0.001; 0.71 vs 0.59, P < 0.01; 0.81 vs 0.49, P < 0.05, respectively). However, there was no significant difference in the median location coefficient of the HCC in the lateral segment between in the CR and in the non-CR groups(0.67 vs 0.65, P > 0.05). On the other hand, in the Child-Pugh grade B patients, the HCC median location coefficient in each lobe and segment was not significantly different between in the CR and in the non-CR groups.CONCLUSION Improved TACE efficacy may be obtained for HCC in the peripheral zone of the right lobe and the medial segment in Child-Pugh grade A patients.

Clinical efficacy of angina pectoris after pci in patients with coronary heart disease complicated with type 2 diabetes by Yiqi Yangyin and Huatan Tongluo recipe

Objective:To evaluate the clinical efficacy of Yiqi Yangyin and Huatan Tongluo Recipe in improving the symptoms of angina pectoris and cardiac function in patients with coronary heart disease complicated with type 2 diabetes after PCI.Methods Sixty-two patients with coronary heart disease complicated with type 2 diabetes after PCI were randomly divided into treatment group and control group,with 31 patients in each group.Both groups were treated with western medicine.The treatment group added Yiqi Yangyin and Huayu Tongluo Recipe granules.The changes of metabolic equivalent(METs),angina symptoms,TCM symptoms,BNP,hypersensitive C-reactive protein(hs-CRP),Interleukin-6(IL-6),Tumor necrosis factor-(TNF-α)and left ventricular ejection fraction(LVEF)were analyzed after 1 course of treatment and Corrected TIMI Frame Count(CTFC)after six month.Results The improvement of METS and LVEF in the treatment group was better than that in the control group(P<0.05);the improvement of BNP,hs-CRP,IL-6,TNF-αand CTFC in the treatment group was better than that in the control group;the curative effect of angina pectoris in the treatment group was better than that in the control group;the effective rate of TCM syndrome improvement in the treatment group was better than that in the control group.Conclusion Yiqi Yangyin and Huatan Tongluo Recipe can effectively alleviate angina pectoris symptoms in patients with coronary heart disease complicated with type 2 diabetes after PCI,suggesting cardiac function,inhibiting inflammatory response,and improving microcirculation disturbance.

Application of the Objective Structure Clinical Evaluation in Evaluating Clinical Competence for a BSN Program

Given the complex clinical situations and the dynamic nature of nursing, the greatest challenge for nursing educators is performing objective evaluation of students’ clinical competence. The Objective Structured Clinical Evaluation (OSCE) is designed to address this challenge and it has been widely used in nursing education. However, its implementation in nursing education in Taiwan has been limited. Accordingly, a quasi-experimental design was utilized to examine students’ clinical performance and stress levels using a 12-station OSCE assessment. Further, we investigated the inter-rater reliability and internal consistency of the OSCE. After controlling for scores of clinical performance, overall differences in pre- and post-practicum stress in the OSCE group were significantly higher than in the control group (F (1, 89) = 4.89, p = 0.03). There was no group effect on practicum performance after controlling for grade point average (F (1, 89) = 2.69, p = 0.14). Cronbach’s alpha for 12 OSCE stations ranged from 0.22 to 0.80 and inter-rater reliability for all 12 stations showed Pearson’s r ranging between 0.76 and 1.00. Cohen’s kappa ranged from 0.70 to 1.00

Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis

Objective This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy(IMRT) for cervical cancer complicated with pelvic lymph node metastasis. Methods Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared. Results The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group(P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group(P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups(P > 0.05). The radiation doses of Dmax in the small intestine, D1 cc(the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2 cc(the minimum dose to the 2 cc receiving the highest dose) between the two groups(P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower(P < 0.05) than in the late-course dose-increasing IMRT group.Conclusion The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.

Exploration of Therapeutic Measures and Clinical Efficacy for Recurrent Respiratory Infections in Children

Objective:To explore the treatment strategies and clinical effects for recurrent respiratory infections in children.Methods:From May 2022 to May 2024,100 pediatric patients with recurrent respiratory infections were selected in this study and evenly divided into two groups.The control group(50 patients)was treated with conventional therapy supplemented with budesonide,while the observation group(50 patients)received pidotimod treatment in addition to the control group’s treatment.Subsequently,the duration of clinical symptom improvement,respiratory function enhancement,serological index changes,reinfection status,and parental satisfaction were compared between the two groups.Results:In terms of clinical symptoms,the observation group showed significantly shorter durations of fever reduction,cough relief,tonsil swelling reduction,and disappearance of fine wet rales compared to the control group(average reduction times were 1.6 days,2.3 days,2.1 days,and 1.9 days,respectively,P<0.05).Regarding respiratory function,the observation group experienced a 12%increase in peak expiratory flow rate variability,a 0.6-liter increase in lung capacity,a 0.7-liter increase in forced lung capacity,and a 0.5-liter increase in forced expiratory volume in the first second after treatment,all significantly higher than the control group(P<0.05).Serological testing revealed that interferon-γand interleukin-2 levels increased by 15%and 18%,respectively,while interferon-α,interleukin-5,and interleukin-4 levels decreased by 10%,12%,and 9%,respectively,in the observation group,showing significant differences compared to the control group(P<0.05).Additionally,the reinfection rate in the observation group(10%)was significantly lower than that in the control group(30%),with an average reduction of two reinfections within one year and a 3.2-day shorter infection control time(P<0.05).In terms of parental satisfaction,the observation group achieved 95%,significantly higher than the 70%in the control group(P<0.05).Conclusion:The addition of pidotimod to conventional therapy for pediatric patients with recurrent respiratory infections can significantly alleviate clinical symptoms,promote the recovery of respiratory function,regulate serological indicators,effectively reduce the risk of reinfection,and improve parental satisfaction.This method deserves widespread clinical application.

Efficacy evaluation and survival analysis of the combination of oxaliplatin plus Teysuno (SOX) with immune checkpoint inhibitors in the conversion therapy of locally advanced gastric cancer

Background:The efficacy of combining immune checkpoint inhibitors(ICIs)with chemotherapy in neoadjuvant therapy for locally advanced gastric cancer has been explored.However,limited research exists on its effectiveness in conversion therapy,and its superiority over standalone chemotherapy remains to be elucidated.This study aims to investigate the efficacy and survival outcomes of patients treated with ICIs in combination with conversion therapy for locally advanced gastric cancer.Methods:Retrospective data from patients with locally advanced gastric cancer treated with either oxaliplatin+S-1(SOX)alone or in combination with ICIs in conversion therapywere collected.Clinical andpathological characteristics,disease-free survival,andefficacy assessments in nonoperable patients were compared between the 2 treatment groups.Efficacy was further evaluated through dynamic changes in serum markers,and patients’quality of life was assessed using the QLQ-STO22(Gastric Cancer–Specific Quality of Life Questionnaire)quality-of-life measurement scale.Results:A total of 140 patients underwent conversion therapy:80 in the SOX alone group and 60 in the SOX combined with the ICIs group.There were no significant differences in baseline characteristics between the 2 groups.Compared with the SOX alone group,the SOX combined with ICIs group exhibited a higher conversion rate(83.3%vs 75%,P=0.23),R0 resection rate(90.0%vs 83.3%,P=0.31),pathological complete response(pCR)rate(18%vs 5%,P=0.02),median disease-free survival(21.4 vs 16.9 months,P=0.007),the objective response rate in nonoperable patients(60%vs 40%,P=0.301),and median progression-free survival time(7.9 vs 5.7 months,P=0.009).The QLQ-STO22 quality-of-life assessment revealed statistically significant improvements in pain,swallowing difficulties,and dietary restrictions in the combination therapy group compared with those in the monotherapy group.The enhanced efficacy of immune combination with SOX is evident,as demonstrated by the significantly prolonged surgical duration in operated patients(206.6±26.6 min vs 197.8±19.8 min,P=0.35)and intraoperative blood loss(158.9±21.2 mL vs 148.9±25.1 mL,P=0.59).No significant differences were observed in postoperative complications.Conclusions:Compared with the SOX conversion therapy regimen,SOX combined with ICIs demonstrated higher conversion rates,R0 resection rates,pathological response rates,and disease-free survival without increasing surgical difficulty or complications.Nonoperable patients also experienced longer progression-free survival and objective response rates.

Effect of Aidi injection combined with transcatheter arterial chemoembolization on clinical efficacy, vascular growth factor and cellular immune function in patients with primary liver cancer

Objective:To investigate the clinical effect of Aidi injection combined with TACE on patients with primary liver cancer and its influence on serum AFP,bFGF,VEGF,inflammatory cytokines,immune function and quality of life.Methods From June 2017 to June 2019,116 patients with primary liver cancer from Shanghai Yangsi hospital and Zhongshan Hospital Affiliated to Fudan University were selected as the study objects.They were randomly divided into TACE group and TACE+Aidi group with 58 cases in each group.The TACE group was treated with TACE.The clinical efficacy,serum tumor markers,bFGF,VEGF,TGF-beta 1,oxidative stress,inflammatory cytokines,cellular immune function and quality of life were observed.Results The total effective rate was 89.66%in the case group,which was significantly higher than 74.14%in the TACE group,The difference was statistically significant(P<0.05).After treatment,the levels of alpha-fetoprotein(AFP),carbohydrate chain antigen(CA)242,CA724,basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF),transforming growth factor-beta 1(TGF-beta),malondialdehyde(MDA),interleukin(IL)-6,IL-10,tumor necrosis factor(TNF)-a,circulating immune complex(CIC),CD8+in the two groups were lower than those before treatment;total antioxidant capacity(TAOC),measurement The levels of superoxide dismutase(SOD),IL-12,CD3+,CD4+,CD4+/CD8+and QOL scores of quality of life were higher than those before treatment.The serum tumor markers,bFGF,VEGF,TGF-beta 1,oxidative stress,inflammatory cytokines,cellular immune function and quality of life in theTACE+Aidi group were significantly better than those in the TACE group.The difference was statistically significant(P<0.05).The incidence of adverse reactions in theTACE+Aidi group was 6.89%,which was lower than 13.78%in the TACE group,There was no significant difference(P>0.05).Conclusions Addie injection combined with transcatheter arterial chemoembolization is effective in treating primary liver cancer,reducing serum tumor markers,reducing toxic and side effects,regulating oxidative stress,reducing inflammatory reaction,reducing serum bFGF,VEGF and TGF-beta 1 levels,improving the quality of life of patients,and has high efficiency and safety,which is worthy of further promotion in clinic.

Clinical efficacy of HEGU needling method combined with tendon-stretching and plucking massage on trigger point in the treatment of acute thoracodorsal myofascitis

Objective:To observe the effect of Hegu neediling method combined with tendon-stretching and plucking massage on trigger point in the treatment of acute thoracodorsal myofascitis. Methods: A total of 84 patients with acute thoracodorsal myofascitis who met the diagnostic and inclusion criteria were assigned into the treatment group and the control group randomly, the treatment group was treated with Hegu neediling method combined with tendon-stretching and plucking massage, while the control group was treated with conventional electroacupuncture. Two groups of patients were treated for two weeks. VAS score and ODI were compared before treatment, after the first treatment and after the treatment course, and the clinical efficacy was evaluated after treatment.Results: The total effective rates of the treatment group and the control group were 97.62% and 80.95%, respectively. The treatment group was significantly better than the control group. The VAS and ODI scores of the treatment group decreased after the first treatment and the end of the treatment, and the treatment group was significantly better than the control group.Conclusion:Hegu neediling method combined with tendon-stretching and plucking massage can relieve pain and improve limb dysfunction in patients with acute thoracodorsal myofascitis.

The Diagnostic and Prognostic Value of Serum Procalcitonin among Ventilator Associated Pneumonia Patients

Ventilator-associated pneumonia (VAP) is a complication in as many as 28% of patients who receive mechanical ventilation. Studies have consistently shown that a delay in diagnosis and treatment increases the mortality risk. The aim of this work was to clarify the role of the serum procalcitonin (PCT) in the diagnosis and the prognosis of ventilator associated pneumonia. Methods: Forty two VAP patients, 20 non VAP-ICU (on mechanical ventilation) admitted patients and 20 healthy control subjects of similar age and sex were included in the study. PCT levels in serum samples were measured in all subjects. Results: There was a highly statistically significant difference (p value 0.001) between VAP patients on one side and non VAP-ICU patients and healthy control subjects on the other side regarding the mean values of PCT. Also, the mean values of PCT were statistically significantly higher (p 0.001) among died VAP group than the survivor VAP group. There was a statistically positive correlation (p = 0.449), CRIP (R = 0.403) and SOFA (R = 0.437)) and initial PCT serum levels. Conclusions: This study found that the increased PCT serum level is an important diagnostic tool for VAP and the PCT serum levels can predict the outcome of VAP patients. We recommend other larger studies to augment our findings.

Subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy for the treatment of slow transit constipation in an aged population:A retrospective control study

AIM To compare the efficacy,improved quality of life,and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy(SCBAC) or subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy(SCBCAC) for the treatment of slow transit constipation.METHODS Between October 2010 and October 2014,aged patients with slow transit constipation who were hospitalized and underwent laparoscopic surgery in our institute weredivided into two groups: the bypass group,15 patients underwent SCBAC,and the bypass plus colostomy group,14 patients underwent SCBCAC. The following preoperative and postoperative clinical data were collected: gender,age,body mass index,operative time,first flatus time,length of hospital stay,bowel movements(BMs),Wexner fecal incontinence scale,Wexner constipation scale(WCS),gastrointestinal quality of life index(GIQLI),numerical rating scale for pain intensity(NRS),abdominal bloating score(ABS),and ClavienDindo classification of surgical complications(CD) before surgery and at 3,6,12,and 24 mo after surgery.RESULTS All patients successfully underwent laparoscopic surgery without open surgery conversion or surgeryrelated death. The operative time and blood loss were significantly less in the bypass group than in the bypass plus colostomy group(P = 0.007). No significant differences were observed in first flatus time,length of hospital stay,or complications with CD > 1 between the two groups. No patients had fecal incontinence after surgery. At 3,6,and 12 mo after surgery,the number of BMs was significantly less in the bypass plus colostomy group than in the bypass group. The parameters at 3,6,12,and 24 mo after surgery in both groups significantly improved compared with the preoperative conditions(P < 0.05),except NRS at 3,6 mo after surgery in both groups,ABS at 12,24 mo after surgery and NRS at 12,24 mo after surgery in the bypass group. WCS,GIQLI,NRS,and ABS significantly improved in the bypass plus colostomy group compared with the bypass group at 3,6,12,and 24 mo after surgery(P < 0.05) except WCS,NRS at 3,6 mo after surgery and ABS at 3 mo after surgery. At 1 year after surgery,a barium enema examination showed that the emptying time was significantly better in the bypass plus colostomy group than in the bypass group(P = 0.007).CONCLUSION Laparoscopic SCBCAC is an effective and safe procedure for the treatment of slow transit constipation in an aged population and can significantly improve the prognosis. Its clinical efficacy is more favorable compared with that of SCBAC. Laparoscopic SCBCAC is a better procedure for the treatment of slow transit constipation in an aged population.

Clinical efficacy of laparoscopic cholecystectomy plus cholangioscopy for the treatment of cholecystolithiasis combined with choledocholithiasis

BACKGROUND Currently,endoscopic retrograde cholangiopancreatography(ERCP)plus laparoscopic cholecystectomy(LC)is the main treatment for cholecystolithiasis combined with choledocholithiasis.However,the treatment is unsatisfactory,and the development of better therapies is needed.AIM To determine the clinical efficacy of LC plus cholangioscopy for cholecystolithiasis combined with choledocholithiasis.METHODS Patients(n=243)with cholecystolithiasis and choledocholithiasis admitted to The Affiliated Haixia Hospital of Huaqiao University(910th Hospital of Joint Logistic Support Force)between January 2019 and December 2023 were included in the study;111 patients(control group)underwent ERCP+LC and 132 patients(observation group)underwent LC+laparoscopic common bile duct exploration(LCBDE).Surgical success rates,residual stone rates,complications(pancreatitis,hyperamylasemia,biliary tract infection,and bile leakage),surgical indicators[intraoperative blood loss(IBL)and operation time(OT)],recovery indices(postoperative exhaust/defecation time and hospital stay),and serum inflammatory markers[C-reactive protein(CRP)],tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were compared.RESULTS No significant differences in surgical success rates and residual stone rates were detected between the observation and control groups.However,the complication rate,IBL,OT,postoperative exhaust/defecation time,and hospital stays were significantly reduced in the observation group compared with the control group.Furthermore,CRP,TNF-α,and IL-6 Levels after treatment were reduced in the observation group compared with the levels in the control group.CONCLUSION These results indicate that LC+LCBDE is safer than ERCP+LC for the treatment of cholecystolithiasis combined with choledocholithiasis.The surgical risks and postoperative complications were lower in the observation group compared with the control group.Thus,patients may recover quickly with less inflammation after LCBDE.

challenges of advanced hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is an aggressive malignancy,resulting as the third cause of death by cancer each year. The management of patients with HCC is complex,as both the tumour stage and any underlying liver disease must be considered conjointly. Although surveillance by imaging,clinical and biochemical parameters is routinely performed,a lot of patients suffering from cirrhosis have an advanced stage HCC at the first diagnosis. Advanced stage HCC includes heterogeneous groups of patients with different clinical condition and radiological features and sorafenib is the only approved treatment according to Barcelona Clinic Liver Cancer. Since the introduction of sorafenib in clinical practice,several phase Ⅲ clinical trials have failed to demonstrate any superiority over sorafenib in the frontline setting. Locoregional therapies have also been tested as first line treatment,but their role in advanced HCC is still matter of debate. No single agent or combination therapies have been shown to impact outcomes after sorafenib failure. Therefore this review will focus on the range of experimental therapeutics for patients with advanced HCC and highlights the successes and failures of these treatments as well as areas for future development. Specifics such as dose limiting toxicity and safety profile in patients with liver dysfunction related to the underlying chronic liver disease should be considered when developing therapies in HCC. Finally,robust validated and reproducible surrogate end-points as well as predictive biomarkers should be defined in future randomized trials.

Clinical Efficacy Observation on Dysmenorrhea of Cold-damp Stagnation Type with Graphene Thermotherapy Based on the Idea of TCM "Preventive Treatment of Disease"

[Objectives] To explore the clinical efficacy of graphene waist protector on dysmenorrhea of cold-damp stagnation type.[Methods]150 patients with cold-damp stagnation type were randomly divided into 3 groups: 50 cases in the experimental group( using graphene waist protector),49 cases in the blank group( using the waist protector for removing the heating plate) and 51 cases in the control group( taking the Tongjingbao granules). After intervening for 3 menstrual cycles,visual analogue scale and the COX menstrual symptom scale were used to evaluate the clinical efficacy of graphene waist protector. [Results] The clinical effective rate of dysmenorrhea in experimental group was 64. 00%,while that of control group was 72. 54%. With the effective rate of symptoms,the test group was 56. 00% and the control group was 64. 70%; VAS dysmenorrhea visual score,duration of dysmenorrhea,severity of COX dysmenorrhea and duration of symptoms after intervention were significantly decreased in both experimental group and control group,the differences were statistically significant( P < 0. 05); for the differences of the scores before and after the intervention: the differences of the experimental group and the control group were statistically significant( P < 0. 05) compared with those of the blank group. There was no significant difference between experimental group and control group( P > 0. 05). [Conclusions] Graphene belt of experimental group and Tongjingbao granules of control group both have therapeutic effects on dysmenorrhea of cold-damp stagnation type. Graphene waist protector can relieve the pain and its accompanying symptoms in patients with primary dysmenorrhea of cold-damp stagnation type.

Understanding the molecular mechanisms of cancer prevention by dietary phytochemicals:From experimental models to clinical trials

Chemoprevention is one of the cancer prevention approaches wherein natural/synthetic agent(s) are prescribed with the aim to delay or disrupt multiple pathways and processes involved at multiple steps, i.e., initiation, promotion, and progression of cancer. Amongst environmental chemopreventive compounds, diet/beverage-derived components are under evaluation, because of their long history of exposure to humans, high tolerability, low toxicity, and reported biological activities. This compilation briefly covers and compares the available evidence on chemopreventive efficacy and probable mechanism of chemoprevention by selected dietary phytochemicals(capsaicin, curcumin, diallyl sulphide, genistein, green/black tea polyphenols, indoles, lycopene, phenethyl isocyanate, resveratrol, retinoids and tocopherols) in experimental systems and clinical trials. All the dietary phytochemicals covered in this review have demonstrated chemopreventive efficacy against spontaneous or carcinogen-induced experimental tumors and/or associated biomarkers and processes in rodents at several organ sites. The observed anti-initiating, anti-promoting and anti-progression activity of dietary phytochemicals in carcinogen-induced experimental models involve phytochemical-mediated redox changes, modulation of enzymes and signaling kinases resulting to effects on multiple genes and cell signaling pathways. Results from clinical trials using these compounds have not shown them to be chemopreventive. This may be due to our:(1) inability to reproduce the exposure conditions, i.e., levels, complexity, other host and lifestyle factors; and(2) lack of understanding about the mechanisms of action and agent-mediated toxicity in several organs and physiological processes in the host. Current research efforts in addressing the issues of exposure conditions, bioavailability, toxicity and the mode of action of dietary phytochemicals may help address the reason for observed mismatch that may ultimately lead to identification of new chemopreventive agents for protection against broad spectrum of exposures.

Influence of Yishen Guben Qutong decoction combined with menatetrenone soft capsule on bone metabolism,bone conversion index and clinical efficacy in osteoporosis patients

Objective:To observe the effect of tetradecylene naphthalene soft capsule combined with Yishen Gubenyutong Decoction on bone metabolism and bone turnover in patients with osteoporosis and its clinical efficacy.Methods:A total of 100 patients with primary osteoporosis(all were treated by our hospital from February 2017 to June 2018)were divided into two groups.The control group(50 cases)was given to menatetrenone capsules.Treatment,observation group(50 cases)combined with Yishen Gubenqiaotongtong on the basis of the treatment of the control group,6 months for a course of treatment.The bone metabolic markers,bone mineral density changes and clinical efficacy were measured before and after treatment.Results:The total effective rate of the observation group was higher than that of the control group.After treatment,the observation group showed serum calcium(Ca),serum alkaline phosphatase(ALP)and typeⅠcollagen.The level of cross-linked C-terminal peptide(CTX-1)was lower than that of the control group.After treatment,the osteocalcin(OC)in the observation group was higher than that in the control group,and the bone mineral density(BMD)of lumbar vertebrae L2-4,femoral neck and femur trochanter in the observation group were higher than those in the control group.Conclusion:Menatetrenone soft capsule combined with Yishen Gubenyutong Decoction has good clinical effect on osteoporosis patients and it is worth further promotion in clinic.

Advanced hepatocellular carcinoma and sorafenib: Diagnosis, indications, clinical and radiological follow-up

Advanced stage hepatocellular carcinoma(HCC) is a category of disease defined by radiological, clinical and hepatic function parameters, comprehending a wide range of patients with different general conditions. The main therapeutic option is represented by sorafenibtreatment, a multi-kinase inhibitor with anti-proliferative and anti-angiogenic effect. Trans-arterial Radio Embolization also represents a promising new approach to intermediate/advanced HCC. Post-marketing clinical studies showed that only a portion of patients actually benefits from sorafenib treatment, and an even smaller percentage of patients treated shows partial/complete response on follow-up examinations, up against relevant costs and an incidence of drug related adverse effects. Although the treatment with sorafenib has shown a significant increase in mean overall survival in different studies, only a part of patients actually shows real benefits, while the incidence of drug related significant adverse effects and the economic costs are relatively high. Moreover, only a small percentage of patients also shows a response in terms of lesion dimensions reduction. Being able to properly differentiate patients who are responding to the therapy from non-responders as early as possible is then still difficult and could be a pivotal challenge for the future; in fact it could spare several patients a therapy often difficult to bear, directing them to other second line treatments(many of which are at the moment still under investigation). For this reason, some supplemental criteria to be added to the standard modified Response Evaluation Criteria in Solid Tumors evaluation are being searched for. In particular, finding some parameters(cellular density, perfusion grade and enhancement rate) able to predict the sensitivity of the lesions to anti-angiogenic agents could help in stratifying patients in terms of treatment responsiveness before the beginning of the therapy itself, or in the first weeks of sorafenib treatment. This would bring a strongly desirable help in clinical managements of these patients.

Ganoderma lucidum:a comprehensive review of phytochemistry,efficacy,safety and clinical study

Ganoderma lucidum,one of the most well-known edible fungi,is believed to be very beneficial for longevity and vitality.A long usage history suggests that G.lucidum has various clinical therapeutic effects.And experimental studies have confirmed that G.lucidum has multiple pharmacological effects,including antitumor,anti-microbial,anti-HIV protease,and antidiabetic activity and so on.With the deepening of research,more than 300 compounds have been isolated from G.lucidum.There is an increasing population of G.lucidum-based products,and its international development is expanding.Currently,G.lucidum has drawn much attention to its chemical composition,therapeutic effect,clinical value,and safety.This paper provides a comprehensive review of these aspects to enhance the global promotion of G.lucidum.

Evaluation of the clinical effects of atropine in combination with remifentanil in children undergoing surgery for acute appendicitis

BACKGROUND Acute appendicitis(AA)is the most common cause of acute abdomen in children.Anesthesia significantly influences the surgical treatment of AA in children,making the scientific and effective selection of anesthetics crucial.AIM To assess the clinical effect of atropine(ATR)in combination with remifentanil(REMI)in children undergoing surgery for AA.METHODS In total,108 cases of pediatric AA treated between May 2020 and May 2023 were selected,58 of which received ATR+REMI[research group(RG)]and 50 who received REMI[control group(CG)].Comparative analyses were conducted on the time to loss of eyelash reflex,pain resolution time,recovery time from anesthesia,incidence of adverse events(AEs;respiratory depression,hypoxemia,bradycardia,nausea and vomiting,and hypotension),intraoperative responses(head shaking,limb activity,orientation recovery,safe departure time from the operating room),hemodynamic parameters[oxygen saturation(SPO2),mean arterial pressure,heart rate,and respiratory rate],postoperative sedation score(Ramsay score),and pain level[the Face,Legs,Activity,Cry,Consolability(FLACC)Behavioral Scale].RESULTS Compared with the CG,the RG showed significantly shorter time to loss of eyelash reflex,pain resolution,recovery from anesthesia,and safe departure from the operating room.Furthermore,the incidence rates of overall AEs(head shaking,limb activity,etc.)were lower,and influences on intraoperative hemodynamic parameters and stress response indexes were fewer.The Ramsay score at 30 min after extubation and the FLACC score at 60 min after extubation were significantly lower in the RG than in the CG.CONCLUSION ATR+REMI is superior to REMI alone in children undergoing AA surgery,with a lower incidence of AEs,fewer influences on hemodynamics and stress responses,and better post-anesthesia recovery.

Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis

BACKGROUND To compare the efficacy and safety of total neoadjuvant therapy(TNT)and neoadjuvant chemoradiotherapy(nCRT)in the treatment of middle and low locally advanced rectal cancer.Our study will systematically collect and integrate studies to evaluate the ability of these two treatments to improve tumor shrinkage rates,surgical resection rates,tumor-free survival,and severe adverse events.AIM To provide clinicians and patients with more reliable treatment options to optimize treatment outcomes and quality of life for patients with locally advanced rectal cancer by comparing the advantages and disadvantages of the two treatment options.METHODS A full search of all clinical studies on the effectiveness and safety of TNT and nCRT for treating locally advanced rectal cancer identified in Chinese(CNKI,Wanfang,China Biomedical Literature Database)and English(PubMed,Embase)databases was performed.Two system assessors independently screened the studies according to the inclusion and exclusion criteria.Quality evaluation and RESULTS Finally,14 studies were included,six of which were randomized controlled studies.A total of 3797 patients were included,including 1865 in the TNT group and 1932 in the nCRT group.The two sets of baseline data were comparable.The results of the meta-analysis showed that the pCR rate[odds ratio(OR)=1.57,95%confidence interval(CI):1.30-1.90,P<0.00001],T stage degradation rate(OR=2.16,95%CI:1.63-2.57,P<0.00001),and R0 resection rate(OR=1.42,95%CI:1.09-1.85,P=0.009)were significantly greater in the nCRT group than in the nCRT group.There was no significant difference in the incidence of grade 3/4 acute toxicity or perioperative complications between the two groups.The 5-year OS[hazard ratio(HR)=0.84,95%CI:0.69-1.02,P=0.08]and DFS(HR=0.94,95%CI:0.03-1.39,P=0.74)of the TNT group were similar to those of the nCRT group.CONCLUSION TNT has greater clinical efficacy and safety than nCRT in the treatment of locally advanced rectal cancer.