AIM: To characterize the efficacy of rifaximin in the management of hepatic encephalopathy (HE) as several randomized controlled studies have shown contradictory results on its effectiveness in comparison to other ora...AIM: To characterize the efficacy of rifaximin in the management of hepatic encephalopathy (HE) as several randomized controlled studies have shown contradictory results on its effectiveness in comparison to other oral agents. METHODS: We performed a systematic review and random effects meta-analysis of all eligible trials identifi ed through electronic and manual searches. Twelve randomized controlled trials met the inclusion criteria with a total of 565 patients. RESULTS: The clinical effectiveness of rifaximin was equivalent to disaccharides or other oral antibiotics[odds ratio (OR) 0.96; 95% CI: 0.94-4.08] but with a better safety profi le (OR 0.27; 95% CI: 0.12-0.59). At the completion of treatment protocols, patients receiving rifaximin showed lower serum ammonia levels [weighted mean difference (WMD) = -10.65; 95% CI: -23.4-2.1; P = 0.10], better mental status (WMD = -0.24; 95% CI: -0.57-0.08; P = 0.15) and less asterixis (WMD -0.1; 95% CI -0.26-0.07; P = 0.25) without reaching statistical signifi cance. On the other hand, other psychometric outcomes such as electroencephalographic response and grades of portosystemic encephalopathy were superior in patients treated with rifaximin in comparison to the control group (WMD = 0.21, 95% CI: -0.33-0.09, P = 0.0004; and WMD = -2.33, 95% CI: -2.68-1.98, P = 0.00001, respectively). Subgroup and sensitivity analysis did not show any signifi cant difference in the above fi ndings. CONCLUSION: Rifaximin appears to be at least as effective as other conventional oral agents for the treatment of HE with a better safety profi le.展开更多
OBJECTIVE To evaluate the response rate and tolerance of patients with middle-late esophageal carcinoma, who were treated with concurrent chemoradiotherapy （CCRT） plus thalidomide.METHODS Sixty-five eligible patient...OBJECTIVE To evaluate the response rate and tolerance of patients with middle-late esophageal carcinoma, who were treated with concurrent chemoradiotherapy （CCRT） plus thalidomide.METHODS Sixty-five eligible patients with local middle-late esophageal carcinoma were randomly assigned to the treatment group （TG） and the control group （CG）. The 33 patients from the TG were treated with CCRT plus thalidomide （a 60-70 Gy of radiation dose, and 5-FU plus cisplatin; oral administration of thalidomide at a dose of 100 mg/d on the first week and 200 mg/d on the second. Both were taken with water, at bedtime until completion of the radiotherapy. In the CG, 32 patients received CCRT only. The clinical effects and tolerance to the CCRT between the 2 groups were compared.RESULTS The response rates of the therapeutic combination in the TG and CG were 87.9% and 68.7%, respectively. There were no statistical differences in comparing the response rates between the 2 groups （P 〉 0.05）; the local control rates in the TG and CG were 93% and 91%, respectively, and there were no statistical differences between the 2 groups （P 〉 0.05）; the 1-year survival rates of the patients in the TG and CG were 74.0% and 63.0%, respectively, without statistical differences between the 2 groups （P 〉 0.05）. The improvement rates of KPS scoring in the TG and CG were 57.6% and 31.3%, respectively. There were significant differences in comparing the improvement rates between the 2 groups （P 〈 0.05）. The incidence rates of nausea and vomiting were lower in the TG compared to the CG, with a statistical significance between the 2 groups （P 〈 0.05）. However, the incidence rates of constipation, lethargy and fatigue were higher in the TG than in CG, showing a statistically significant difference between the 2 groups （P 〈 0.05）. CONCLUSION CCRT combined with thalidomide in treating esophageal carcinoma may improve the quality of life of the patients, the treatment may also raise patients＇ compliance to chemoradiotherapy, and possibly increase their long-term survival rate. Further studies related to this topic are needed.展开更多
The effects of Chinese medicines on micro-circulation and blood flow velocity in arteries of the lower limbs were observed in 33 patients with arteriosclerotic obliteration(ASO).The results showed that the integral va...The effects of Chinese medicines on micro-circulation and blood flow velocity in arteries of the lower limbs were observed in 33 patients with arteriosclerotic obliteration(ASO).The results showed that the integral values of micro-circulation after treatment were obviously higher than those before treatment (P<0.05 or P<0.01).Blood flow velocity in arteries of the lower limbs determined with the color Doppler ultrasound detecting method after treatment were also obviously higher than those before treatment (P<0.05 or P<0.01).In tbis series of 33 ASO patients,the markedly effective rate was 36.36%,and the total effective rate was 63.64%.The observation indicates that the recipe prescribed according to the principle of supplementing qi and activating blood circulation can effectively improve micro-circulation in ASO patients,and accelerate blood flow in arteries of the lower limbs.展开更多
文摘AIM: To characterize the efficacy of rifaximin in the management of hepatic encephalopathy (HE) as several randomized controlled studies have shown contradictory results on its effectiveness in comparison to other oral agents. METHODS: We performed a systematic review and random effects meta-analysis of all eligible trials identifi ed through electronic and manual searches. Twelve randomized controlled trials met the inclusion criteria with a total of 565 patients. RESULTS: The clinical effectiveness of rifaximin was equivalent to disaccharides or other oral antibiotics[odds ratio (OR) 0.96; 95% CI: 0.94-4.08] but with a better safety profi le (OR 0.27; 95% CI: 0.12-0.59). At the completion of treatment protocols, patients receiving rifaximin showed lower serum ammonia levels [weighted mean difference (WMD) = -10.65; 95% CI: -23.4-2.1; P = 0.10], better mental status (WMD = -0.24; 95% CI: -0.57-0.08; P = 0.15) and less asterixis (WMD -0.1; 95% CI -0.26-0.07; P = 0.25) without reaching statistical signifi cance. On the other hand, other psychometric outcomes such as electroencephalographic response and grades of portosystemic encephalopathy were superior in patients treated with rifaximin in comparison to the control group (WMD = 0.21, 95% CI: -0.33-0.09, P = 0.0004; and WMD = -2.33, 95% CI: -2.68-1.98, P = 0.00001, respectively). Subgroup and sensitivity analysis did not show any signifi cant difference in the above fi ndings. CONCLUSION: Rifaximin appears to be at least as effective as other conventional oral agents for the treatment of HE with a better safety profi le.
文摘OBJECTIVE To evaluate the response rate and tolerance of patients with middle-late esophageal carcinoma, who were treated with concurrent chemoradiotherapy （CCRT） plus thalidomide.METHODS Sixty-five eligible patients with local middle-late esophageal carcinoma were randomly assigned to the treatment group （TG） and the control group （CG）. The 33 patients from the TG were treated with CCRT plus thalidomide （a 60-70 Gy of radiation dose, and 5-FU plus cisplatin; oral administration of thalidomide at a dose of 100 mg/d on the first week and 200 mg/d on the second. Both were taken with water, at bedtime until completion of the radiotherapy. In the CG, 32 patients received CCRT only. The clinical effects and tolerance to the CCRT between the 2 groups were compared.RESULTS The response rates of the therapeutic combination in the TG and CG were 87.9% and 68.7%, respectively. There were no statistical differences in comparing the response rates between the 2 groups （P 〉 0.05）; the local control rates in the TG and CG were 93% and 91%, respectively, and there were no statistical differences between the 2 groups （P 〉 0.05）; the 1-year survival rates of the patients in the TG and CG were 74.0% and 63.0%, respectively, without statistical differences between the 2 groups （P 〉 0.05）. The improvement rates of KPS scoring in the TG and CG were 57.6% and 31.3%, respectively. There were significant differences in comparing the improvement rates between the 2 groups （P 〈 0.05）. The incidence rates of nausea and vomiting were lower in the TG compared to the CG, with a statistical significance between the 2 groups （P 〈 0.05）. However, the incidence rates of constipation, lethargy and fatigue were higher in the TG than in CG, showing a statistically significant difference between the 2 groups （P 〈 0.05）. CONCLUSION CCRT combined with thalidomide in treating esophageal carcinoma may improve the quality of life of the patients, the treatment may also raise patients＇ compliance to chemoradiotherapy, and possibly increase their long-term survival rate. Further studies related to this topic are needed.
文摘The effects of Chinese medicines on micro-circulation and blood flow velocity in arteries of the lower limbs were observed in 33 patients with arteriosclerotic obliteration(ASO).The results showed that the integral values of micro-circulation after treatment were obviously higher than those before treatment (P<0.05 or P<0.01).Blood flow velocity in arteries of the lower limbs determined with the color Doppler ultrasound detecting method after treatment were also obviously higher than those before treatment (P<0.05 or P<0.01).In tbis series of 33 ASO patients,the markedly effective rate was 36.36%,and the total effective rate was 63.64%.The observation indicates that the recipe prescribed according to the principle of supplementing qi and activating blood circulation can effectively improve micro-circulation in ASO patients,and accelerate blood flow in arteries of the lower limbs.
