Tofacitinib combined with local low-dose ixekizumab injection benefits those with peripheral psoriatic arthritis

Dear Editor,Treating psoriatic arthritis(PsA)is always difficult.Systemic treatments can be administered either orally or through intramuscular and intra-articular injection,including conventional synthetics,biologics and targeted synthetic disease-modifying antirheumatic drugs[1].The alternatives,topical external therapies,are not effective on joint lesions due to drug permeability issues.Drugs injected into the articular cavity are also unsuitable for small peripheral joint lesions,the most common manifestations of PsA.The limited treatment options for PsA present a challenge.

PhaseⅠstudy of chlorogenic acid injection for recurrent high-grade glioma with long-term follow-up

Objective:This study was aimed at analyzing the efficacy and safety of an injectable form of chlorogenic acid(CGA)in patients with recurrent high-grade glioma after standard of care treatments,through a first-in-human,open-label,dose-escalation phase I trial.Methods:A total of 26 eligible patients were enrolled,received intramuscular CGA injections at 5 dose levels,and were followed up for 5 years.CGA was well tolerated,and the maximum tolerated dose was 5.5 mg/kg.Results:The most common treatment-related adverse events occurred at the sites of injection.No grade 3 or 4 adverse events(e.g.,drug allergy)were reported for these patients except for induration at the injection sites.A clinical pharmacokinetic study showed that CGA was rapidly eliminated from the plasma,with a t_(1/2)of 0.95–1.27 h on day 1 and 1.19–1.39 h on day 30,and no detectable CGA was observed on days 9,11,13,23,25,27,and 29 before CGA administration.After the first treatment cycle,52.2%of patients(12 of 23)achieved stable disease.Long-term follow-up indicated an estimated median overall survival of 11.3 months for all 23 evaluable patients.Of the 18 patients with grade 3 glioma,the median overall survival was 9.5 months.Two patients remained alive at the cutoff day.Conclusions:This phase I study demonstrated that CGA has a favorable safety profile(with no severe toxicity),and provides preliminary clinical benefits for patients with high grade glioma relapsing after prior standard therapies,thus shedding light on the potential clinical application of CGA for recurrent grade 4 glioma.

Long-term result of endoscopic Histoacryl （N-butyl-2-cyanoacrylate）injection for treatment of gastric varices

AIM:To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl for treatment of gastric variceal bleeding and prophylaxis.METHODS:Between January 1994 and March 2010 at SoonChunHyang University Hospital,a total of 127 patients with gastric varices received Histoacryl injections endoscopically.One hundred patients underwent endoscopic Histoacryl injections because of variceal bleeding,the other 27 patients received such injections as a prophylactic procedure.RESULTS:According to Sarin classification,56 patients were GOV1,61 patients were GOV2 and 10 patients were IGV.Most of the varices were large(F2 or F3,111 patients).The average volume of Histoacryl per each session was 1.7±1.3 cc and mean number of sessions was 1.3±0.6.(1 session-98 patients,2 sessions-25 patients,≥3 sessions-4 patients).Twenty-seven patients with high risk of bleeding(large or fundal or RCS+or Child C) received Histoacryl injection as a primary prophylactic procedure.In these patients,hepatitis B virus was the major etiology of cirrhosis,25 patients showed GOV1 or 2(92.6%)and F2 or F3 accounted for 88.9%(n=24).The rate of initial hemostasis was 98.4%and recurrent bleeding within one year occurred in 18.1%of patients.Successful hemostasis during episodes of rebleeding was achieved in 73.9%of cases.Median survival was 50 mo (95%CI 30.5-69.5).Major complications occurred in 4 patients(3.1%).The rebleeding rate in patients with hepatocellular carcinoma or GOV2 was higher than in those with other conditions.None of the 27 subjects who were treated prophylactically experienced treatment-related complications.Cumulative survival rates of the 127 patients at 6 mo,1,3,and 5 years were 92.1%,84.2%,64.2%,and 45.3%,respectively.The 6 mo cumulative survival rate of the 27 patients treated prophylactically was 75%.CONCLUSION:Histoacryl injection therapy is an effective treatment for gastric varices and also an effective prophylactic treatment of gastric varices which carry high risk of bleeding.

Effects of heat treatment on the properties of powder injection molded AlN ceramics

The effects of two different heat-treatment atmospheres,nitrogen atmosphere and reducing nitrogen atmosphere with carbon,on the properties of Y2O3-doped aluminum nitride（AlN） ceramics were investigated.The AlN powder as a raw material was synthesized by self-propagating high-temperature synthesis（SHS） and compacts were fabricated by employing powder injection molding technique.The polymer-wax binder consisted of 60 wt.% paraffin wax（PW）,35 wt.% polypropylene（PP）,and 5 wt.% stearic acid（SA）.After the removal of binder,specimens were sintered at 1850°С in nitrogen atmosphere under atmospheric pressure.To improve the thermal conductivity,sintered samples were reheated.The result reveals that the heat-treatment atmosphere has significant effect on the properties and secondary phase of AlN ceramics.The thermal conductivity and density of AlN ceramics reheated in nitrogen gas are 180 W·m^-1·K^-1 and 3.28 g·cm^-3 and the secondary phase is yttrium aluminate.For the sample reheated in reducing nitrogen atmosphere with carbon,the thermal conductivity and density are 173 W·m^-1·K^-1 and 3.23 g·cm^-3,respectively,and the secondary phase is YN.

Tulip bundle technique and fibrin glue injection:Unusual treatment of colonic perforation

We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques.The lesion was large and irregular with three discrete perforations,therefore,we decided to close it by placing one clip per perforation,and then connecting all the clips with two endoloops.Finally we chose to use a fibrin glue injection to obtain a complete sealing.Four days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in situ.Inspection of the sigma showed complete repair of the perforation.This report underlines how a conservative approach,together with a combination of various endoscopic techniques,can resolve complicated iatrogenic perforations of the colon.

Optimal scheme of Shengmai Injection in the treatment of angina pectoris of coronary heart disease based on Louvain algorithm: A real world study

Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and“isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guidelines,but more clinical studies are still needed to explore more effective combination therapy.

Melt Treatment of Al-7%Si Alloy by Flux Injection

The melt treatment of A1-7%Si alloy by the flux injection method in a resistance furnance was investigated. The experimental results show that the flux injection method can realize the melt treatment of A1-7%Si alloy. In purification, the flux injection method is superior to the standard lance degassing method. For the injection flux, the purifier Na2SiF6 is more powerful than Na3A1F6, the modifiers SrCl2, and R.E. Cl3 are quick acting, like NaF, but less powerful, the grain refiner containing K2TiF6 and KBF4 with Ti/B=1 is more potent than that with Ti/B=5. The analytical results indicate that the mass-transfer rate for the flux injection method is much higher than that for the conventional method .

Clinical Observation on Effect of Xuesaitong Injection (血塞通注射液) as Auxiliary Treatment of Severe Craniocerebral Injury

Objective To evaluate the effect of Xuesai-tong injection (XSTI, 血塞通注射液 , a preparation of Panax Notoginseng) as auxilliary treatment of severe craniocerebral injury. Methods Eighty-seven patients with severe craniocerebral injury were selected and randomly divided into the treated group (n=44) and the control group (n = 43), they were treated with conventional treatment, and XSTI was given additionally to the treated group. Intracranial pressure (ICP) and Glasgow coma score (GCS) of all patients were measuredafter 1 or 2-week treatment, and Glasgow outcome scale (GOS) of them was determined 3 months later. Then the therapeutic effect in the two groups were compared. Results After treatment, the ICP was lower, GCS higher and GOS better in the treated group than those in the control group significantly, all showing statistical significance (P<0.05). Conclusion XSTI has marked clinical therapeutic effect in treating patients with severe craniocerebral injury.Original article on CJITWM (Chin) 2004 ;23 (3): 213

COMBINED TREATMENT OF 35 CASES OF FOTHERGILL SYNDROME BY ACUPUNCTURE AND POINT-INJECTION

In the present paper, 35 cases of fothergill syndrome (prosopalgia) of the treatment group were treated with acupuncture and point-injection of VitB12, and 30 cases of the control group were treated with oral administration of carbarnazepine. Results showd that in the trearment group, 6 cases were maredly effective, 27 effective and 2 ineffective, with an effective rate of 94. 29 %; in the control group, 2 cases were markedly effective, 10 effective and 18 ineffective, with an effective rate of 40. 00%. There was a significant difference between the two groups in the effective rate (P < 0.01). The acupuncture therapy is strikingly superior to treatment of prosopalgia with Western medicine and has lower side-effects and a lower recurrence rate.

Development of SA-533 Type B CL. 1+SA-240 Type 304L roll-bonded clad steel plate for safety injection tank of CAP1400 nuclear power plant

Aiming to meet the demand of the country＇ s nuclear demonstration project on the CAP1400 nuclear power plant, Baosteel uses the roll-bonding technology and develops the SA-533 Type B CL. 1 ＋ SA-240 Type 304L high-strength and high-toughness clad steel plate with a shear strength of over 310 MPa for the nuclear power plant＇ s safety injection tank. The properties of the quenched and tempered and the simulated post-weld heat treatment states are systematically studied herein through a comprehensive inspection and evaluation of the composition,microstructure,and properties of the clad steel plate. The results show that the bonding interface has high shear strength and that the base metal has high strength and good toughness at low temperatures. Hence, the performance fully meets the technical requirements of the CAP1400 nuclear power plant＇ s safety injection tank in the country＇ s nuclear demonstration project. The roll-bonded clad steel plate can be used to manufacture the safety injection tank of the CAP1400 nuclear power plant.

Manufacturing of Injection-Molded NdFeB Magnet with (BH)max111 kJ · m-3

The bonded NdFeB magnets prepared by injection molding meet with the development tendency of the magnet in small volume, light weight and high performance ,and have a good prospect.In this paper, a modified nylonbased binder was developed for powder injection molding of NdFeB bonded magnets.The effects of pretreatment of NdFeB anisotropic magnetic powder produced with HDDR processing on the anti-oxidation behaviors of powder and the final magnetic properties of the molded bonded magnets were studied.The optimal powder loading of 65 vol% was achieved with the modified binder.It was found that the properties of the bonded magnets were mainly affected by the powder surface pretreatment and the intensity of the applied alignment magnetic field during injection molding for a certain powder.Bonded magnets with remanence of 0.820 T, intrinsic coercivity of 1140.3 kA· m-1 and maximum energy product of 111 kJ · m-3 were produced with the optimal processing.

Role of platelet-rich plasma in the treatment of rotator cuff tendinopathy

Shoulder pain is a common musculoskeletal complaint,and rotator cuff(RC)pathologies are one of the main causes.The RC undergoes various tendinopathic and avascular changes during the aging process.Other degenerative changes affecting its healing potential make it an appealing target for biological agents.Platelet-rich plasma(PRP)has demonstrated the potential to deliver a high concentration of several growth factors and anti-inflammatory mediators,and its clinical use is mainly supported by experiments that demonstrated its positive effect on muscle,ligaments,and tendinous cells.This review aimed to specify the role of PRP and its future applications in RC tendinopathies based on the current clinical evidence.Due to the different characteristics and conflicting outcomes,clinicians should use PRP with moderate expectations until more consistent evidence is available.However,it is reasonable to consider PRP in patients with contraindications to corticosteroid injections or those with risk factors for inadequate healing.Its autologous origin makes it a safe treatment,and its characteristics make it a promising option for treating RC tendinopathy,but the efficacy has yet to be established.

Injectable treatments for female stress urinary incontinence

The use of injectable agents for the treatment of stress urinary incontinence(SUI)is an option for female patients who are unwilling to undergo surgery,or have concurrent conditions or diseases that render surgical treatment unsuitable.To be effective for SUI,an injectable agent must be nonimmunogenic,hypoallergenic,biocompatible,permanent,nonerosive,nonmigratory and painless.It must also heal with minimal fibrosis,possess a long-term bulking effect,and be easily stored and handled.Glutaraldehyde cross-linked bovine collagen(Contigen),silicone polymers(Macroplastique),Durasphere,calcium hydroxyapatite(Coaptite),polyacrylamide hydrogel(Aquamid,Bulkamid),Permacol,and stem cell therapy have been used as injectable agents.Patients must be informed that treatment with injectable agents is not as effective as surgical treatment,and that such agents might necessitate additional and repeated administrations in order to achieve the desired therapeutic effect.

Inadvertent Application of a Drug Mixture into the Subarachnoid Space When Performing an Outward-Going Lumbar Intervertebral Foramina Injection

An outward-going intervertebral foramina puncture along the side of lumbar vertebra spinous process was used to avoid infusing drugs into the subarachnoid space. However, we still had an inadvertent malpractice. The patient was diagnosed with lumbar discogenic lower back pain and was administrated an outward-going intervertebral foramina puncture through the side of lumbar vertebra spinous process (L5-S1). The drug mixture, containing triamcinolone acetonide suspension, cyanocobalamin and bupivacaine HCl, was injected. The patient had palpitations, chest tightness, dyspnea, bradycardia, and hypotension 3 min right after the injection. The vital signs gradually stabilized after treatment with atropine sulfate;however, he had complete sensorimotor loss below the level of distribution of the T2 spinal nerve. The cerebrospinal fluid pressure was lower in the subarachnoid space and the cerebrospinal fluid was slightly turbid and light pink in color. Six hours later, the sensory, motor, defecation, and urination functions returned to normal level. The patient had follow-up evaluations at 1, 3, and 6 months. The lumbar and hip pain was mild-to-severe at times as usual, but there were no other neurologic sequelae. Conclusions: This case showed that there is a risk that drugs may stray into the subarachnoid space during an outward-going intervertebral foramina puncture through the side of lumbar vertebral spinous process. The complication may occur due to a distal nerve root cyst. The result of triamcinolone acetonide suspension and cyanocobalamin injection into the cerebrospinal fluid was not as serious as we imagined.

CLINICAL STUDY ON THE TIME OF TREATING CHEMOTHERAPY INDUCED TOXIC AND SIDE EFFECTS IN MALIGNANT TUMOR PATIENTS BY ACUPOINT INJECTION OF ASTRAGALUS ROOT INJECTION

Objective: To investigate the suitable time of treating virulent and side effects of chemotherapy for malignant tumor by acupoint injection of Astragalus Root injection. Methods: Sixty three patients with malignant tumor were divided into three groups: prevention treatment (PT) group (n=23 cases),post chemotherapy treatment (PCT) group( n=22 cases), Western medicine (WM) group ( n=18 cases). The patients in PT, PCT and WM groups were treated respectively from the fifth day on before chemotherapy and from the first day on after chemotherapy, 18 days in all. The patients in WM group were administered Batilol and Leucogen from the first day on after chemotherapy. Changes of leukocytes and immunoglobulin before and after treatment were observed. Results: 1) Acupoint injection of Astragalus Root injectio could increase the number of leukocytes and immunoglobulin content and its effect was better than that of Western medicine (P<0.05); 2) The effect of PT group was better than that of PCT group in preventing and treating virulent and side effects of chemotherapy (P<0.05). Conclusion: It should be stressed on prevention of malignant tumor by using acupoint injection of Astragalus Root for relieving virulent and side effects of chemotherapy.

Treatment of Peripheral Neuropathy: Combination Therapy Using LED Light, Extracorporeal Shockwave Therapy, Platelet Rich Plasma, and an Oral Dietary Supplement

Objectives: Peripheral neuropathy (PN) is a significant contributor to disability in the elderly. It is also one of the most prevalent complications of type 2 diabetes, prediabetes and metabolic syndrome. PN is commonly associated with pain, numbness, tingling, burning, and cramping in the feet and legs. Current treatment options are limited to controlling pain, seizures and use of antidepressant medications. These treatments have undesirable side effects and don’t stop PN progression. Here we utilized a combination of individual-specific modalities to improve local circulation and relieve PN symptoms. Methods: We conducted an open-label, multicenter pilot trial with 34 subjects (19 males and 15 females ranging from 40 - 85 years of age). All of the participants were diagnosed with peripheral neuropathy and had bilateral symptoms in their feet, and many reported the same symptoms (pain, numbness, tingling, burning, and cramping) in their lower legs. The duration of symptoms ranged from four months to over six years. On Day 0, subjects were given a 90-day supply of the oral supplement with dosing instructions and a LED light therapy device. They also received three platelet-rich plasma (PRP) injections in their lower extremities. Subjects also received an extracorporeal shockwave therapy (ESWT) treatment for each foot and subsequently twice per week for the first six weeks, then once weekly for the duration of the study. Subjects filled out the Brief Pain Index (BPI) at weekly intervals. On Day 90, subjects completed the Patient Global Impression of Change (PGIC) survey. Results: There were significant responses to pain, as evidenced by BPI scores at weeks 8, 9, 10 and 11 (p = 0.02, 0.01, 0.02, and 0.003, respectively). Analysis of the final day PGIC survey showed a favorable outcome for 73% of participants (p = 0.003), with the majority reporting Very Much Improved. Conclusions: By utilizing a multi-modality treatment protocol that includes PRP, LED light therapy, ESWT and an oral dietary supplement, we observed significant reductions in BPI scores. Quality of life and their overall impression of change (PGIC) were significantly improved, and there were no significant side effects.

Analysis of the Efficacy of Triamcinolone Acetonide Combined with Ranibizumab in the Treatment of Fundus Diseases

Objective:To analyze the effect of triamcinolone acetonide combined with ranibizumab in patients with fundus diseases.Methods:100 patients with fundus diseases admitted from January 2018 to January 2023 were selected.The patients were separated into two groups according to the random number table method,with 50 cases in the control group(treated with ranibizumab),and 50 cases in the observation group(treated with triamcinolone acetonide combined with ranibizumab).The clinical effects of both treatment regimens were compared.Results:The time taken for symptom disappearance of the observation group was shorter than that of the control group(P<0.05).The observation group had higher naked-eye visual acuity(4.18±0.89)compared to the control group.Besides,the observation group also had lower intraocular pressure(14.19±1.33 mmHg)and retinal thickness(283.14±3.29μm),with(P<0.05)compared to the control group.Moreover,the observation group had a lower adverse reaction rate and a higher quality of life(P<0.05).Conclusion:The application of triamcinolone acetonide combined with ranibizumab treatment can quickly relieve the clinical symptoms of patients with fundus disease,improve visual acuity,intraocular pressure,and retinal thickness,with low adverse reaction rate and better prognosis and quality of life.

醒脑静注射液联合立体定向微创治疗对高血压脑出血患者的应用效果

目的探讨醒脑静注射液联合立体定向微创治疗对高血压脑出血患者的应用效果。方法选取2018年1月至2023年1月九江市第一人民医院神经外科收治的80例高血压脑出血患者作为研究对象,根据随机数字表法将患者分为对照组和观察组,每组各40例。对照组采用小骨窗开颅术治疗,观察组采用醒脑静注射液联合立体定向微创治疗。比较两组患者的手术时间、血肿清除率、并发症(包括肺部感染、消化道出血、二次出血)发生率及术后生活自理能力情况。结果观察组的手术时间短于对照组,血肿清除率>80%的比例高于对照组,差异有统计学意义(P<0.05)。观察组术后1个月的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。观察组的术后生活自理能力评分高于对照组,差异有统计学意义(P<0.05)。结论醒脑静注射液联合立体定向微创治疗高血压脑出血患者,可以缩短手术时间,提高血肿清除率,且其并发症相对较少,同时术后患者日常生活自理水平提高明显,值得临床推广应用。

雷珠单抗注射液联合白内障超声乳化治疗白内障合并糖尿病性黄斑水肿的临床研究

目的分析对白内障合并糖尿病性黄斑水肿(DME)应用雷珠单抗注射液与白内障超声乳化(PHACO+IOL)联合治疗的效果。方法选取本院2022年3月—2023年3月收治的白内障并DME患者84例,随机将其均分为两组,对照组采用PHACO+IOL治疗,观察组采用雷珠单抗注射液与PHACO+IOL联合治疗,对比分析两组治疗前后眼压与BCVA以及CMT水平。结果治疗后,两组眼压均有所下降,BCVA水平均有所提升,观察组眼压与对照组不存在明显差异(P>0.05),观察组BCVA明显高于对照组(P<0.05)。术后1个月、3个月、6个月,两组CMT水平明显下降,相比于对照组,观察组更低(P<0.05)。对照组并发症发生率为21.43%,观察组为4.76%,观察组明显更低(P<0.05)。结论在白内障并DME患者临床治疗期间,应用雷珠单抗注射液与白内障超声乳化联合治疗效果理想,可使患者CMT得到有效改善,矫正患者视力,具备较高的推广可行性。

盐酸异丙嗪联合盐酸倍他司汀注射液治疗眩晕症的临床研究

目的探究眩晕症患者应用盐酸异丙嗪联合盐酸倍他司汀注射液的作用。方法方便选取2022年1月—2023年12月昆山市第四人民医院收治的82例眩晕症患者作为研究对象,根据不同治疗方案将其分为研究组和参照组,各41例。参照组行盐酸倍他司汀注射液治疗,研究组加用盐酸异丙嗪治疗。比较两组的治疗效果、临床症状改善情况、眩晕改善情况及不良反应情况。结果研究组治疗有效率为97.56%(40/41),高于参照组的80.49%(33/41),差异有统计学意义(χ^(2)=4.493,P<0.05)。研究组临床症状消失时间短于参照组,差异有统计学意义(P<0.05)。研究组眩晕改善情况优于参照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论盐酸倍他司汀注射液联合盐酸异丙嗪能够提高眩晕症患者的治疗效果,改善患者的临床症状及眩晕情况,且无严重不良反应情况。