The aim was to investigate whether using a removing blood stasis method in hyperacute intracranial hemorrhage stage can lead to hematoma enlargement and its clinical efficacy.A multicenter retrospective randomized dou...The aim was to investigate whether using a removing blood stasis method in hyperacute intracranial hemorrhage stage can lead to hematoma enlargement and its clinical efficacy.A multicenter retrospective randomized double-blind placebo-controlled clinical study.We recruited patients aged 18 years or older and presenting at less than 6 h from symptom onset in 8 research centers.All the patients展开更多
AIM:To investigate the protective effect of erythropoietin (Epo) against ischemia-reperfusion injury (IR/I) following the Pringle maneuver (PM),in comparison with conventional steroid administration in a prospective r...AIM:To investigate the protective effect of erythropoietin (Epo) against ischemia-reperfusion injury (IR/I) following the Pringle maneuver (PM),in comparison with conventional steroid administration in a prospective randomized trial. METHODS:Patients were randomized by age, sex, diagnosis, and surgical method, and assigned to three groups:(1) A steroid group (STRD, n= 9) who received 100 mg of hydrocortisone before PM, and on postoperative days 1, 2 and 3, followed by tapering until postoperative day 7; (2) An EPO1 group (n=10) who received 30 000 U of Epo before the PM and at the end of surgery; and (3) An EPO2 group (n=8) who received 60 000 U of Epo before the PM. Hemoglobin (Hb), hematocrit (Ht), aspartate aminotransferase (AST), alanine transaminase (ALT),lactate dehydrogenase (LDH), lactate, interleukin-6 (IL-6),and tumor necrosis factor(TNF)-α were measured before and just after (Day 0) surgery, and on postoperative days 1, 3, 7 and 14. RESULTS: There were no increases in Hb and Ht in the EPO1 and EPO2 groups. AST was signif icantly lower in EPO1 than in STRD on Day 0 (P=0.041), and lower in EPO1 than in STRD and EPO2 on Day 1 (P=0.018). ALT was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.020) and Day 1 (P=0.004). There were no signif icant inter-group differences in the levels of LDH and lactate. IL-6 was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0036) and Day 1 (P=0.0451). TNF-α was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0006) and Day 1 (P<0.0001). Furthermore, hospitalization was signif icantly shorter in EPO1 and EPO2 than in STRD.CONCLUSION:Epo has greater potential than steroids to ameliorate IR/I after the PM. Epo at a dose of 30000 U, administered before PM and just after surgery, yields better results.展开更多
Background and Aims:Rifaximin is effective in prevent-ing and treating hepatic encephalopathy(HE).This study aimed to investigate the efficacy and safety of different dosages of rifaximin in the treatment of cirrhotic...Background and Aims:Rifaximin is effective in prevent-ing and treating hepatic encephalopathy(HE).This study aimed to investigate the efficacy and safety of different dosages of rifaximin in the treatment of cirrhotic patients with covert HE(CHE).Methods:In this single-center,ran-domized,controlled,open-label study,CHE was diagnosed using a combination of the psychometric HE score and the EncephalApp Stroop test.Cirrhotic patients with CHE were recruited and randomly assigned to low-dose rifaximin 800 mg/day,high-dose rifaximin(1,200 mg/day),and control groups,and were treated for 8 weeks.The sickness impact profile(SIP)scale was used to evaluate the health-relat-ed quality of life(HRQOL)of patients.Forty patients were included in the study,12 were assigned to the low-dose group,14 to the high-dose group,and 14 patients to the control group.Results:The percentage of patients with CHE reversal was significantly higher in both the low-dose(41.67%,5/12)and high-dose(57.14%,8/14)groups than in the control group(7.14%,1/14)at 8 weeks(p=0.037 and p=0.005,respectively).In addition,both doses of ri-faximin resulted in significant improvement of the total SIP score compared with the control group.There were no sig-nificant differences in the CHE reversal rate,total SIP score improvement,and incidence of adverse event between the low-dose and high-dose groups(p>0.05).Conclusions:Low-dose rifaximin reverses CHE and improves HRQOL in cirrhotic patients with comparable effects and safety to high-dose rifaximin.展开更多
文摘The aim was to investigate whether using a removing blood stasis method in hyperacute intracranial hemorrhage stage can lead to hematoma enlargement and its clinical efficacy.A multicenter retrospective randomized double-blind placebo-controlled clinical study.We recruited patients aged 18 years or older and presenting at less than 6 h from symptom onset in 8 research centers.All the patients
基金Supported by (partly) A Research Grant from the Biomarker Society,Japan
文摘AIM:To investigate the protective effect of erythropoietin (Epo) against ischemia-reperfusion injury (IR/I) following the Pringle maneuver (PM),in comparison with conventional steroid administration in a prospective randomized trial. METHODS:Patients were randomized by age, sex, diagnosis, and surgical method, and assigned to three groups:(1) A steroid group (STRD, n= 9) who received 100 mg of hydrocortisone before PM, and on postoperative days 1, 2 and 3, followed by tapering until postoperative day 7; (2) An EPO1 group (n=10) who received 30 000 U of Epo before the PM and at the end of surgery; and (3) An EPO2 group (n=8) who received 60 000 U of Epo before the PM. Hemoglobin (Hb), hematocrit (Ht), aspartate aminotransferase (AST), alanine transaminase (ALT),lactate dehydrogenase (LDH), lactate, interleukin-6 (IL-6),and tumor necrosis factor(TNF)-α were measured before and just after (Day 0) surgery, and on postoperative days 1, 3, 7 and 14. RESULTS: There were no increases in Hb and Ht in the EPO1 and EPO2 groups. AST was signif icantly lower in EPO1 than in STRD on Day 0 (P=0.041), and lower in EPO1 than in STRD and EPO2 on Day 1 (P=0.018). ALT was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.020) and Day 1 (P=0.004). There were no signif icant inter-group differences in the levels of LDH and lactate. IL-6 was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0036) and Day 1 (P=0.0451). TNF-α was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0006) and Day 1 (P<0.0001). Furthermore, hospitalization was signif icantly shorter in EPO1 and EPO2 than in STRD.CONCLUSION:Epo has greater potential than steroids to ameliorate IR/I after the PM. Epo at a dose of 30000 U, administered before PM and just after surgery, yields better results.
文摘Background and Aims:Rifaximin is effective in prevent-ing and treating hepatic encephalopathy(HE).This study aimed to investigate the efficacy and safety of different dosages of rifaximin in the treatment of cirrhotic patients with covert HE(CHE).Methods:In this single-center,ran-domized,controlled,open-label study,CHE was diagnosed using a combination of the psychometric HE score and the EncephalApp Stroop test.Cirrhotic patients with CHE were recruited and randomly assigned to low-dose rifaximin 800 mg/day,high-dose rifaximin(1,200 mg/day),and control groups,and were treated for 8 weeks.The sickness impact profile(SIP)scale was used to evaluate the health-relat-ed quality of life(HRQOL)of patients.Forty patients were included in the study,12 were assigned to the low-dose group,14 to the high-dose group,and 14 patients to the control group.Results:The percentage of patients with CHE reversal was significantly higher in both the low-dose(41.67%,5/12)and high-dose(57.14%,8/14)groups than in the control group(7.14%,1/14)at 8 weeks(p=0.037 and p=0.005,respectively).In addition,both doses of ri-faximin resulted in significant improvement of the total SIP score compared with the control group.There were no sig-nificant differences in the CHE reversal rate,total SIP score improvement,and incidence of adverse event between the low-dose and high-dose groups(p>0.05).Conclusions:Low-dose rifaximin reverses CHE and improves HRQOL in cirrhotic patients with comparable effects and safety to high-dose rifaximin.