康柏西普对糖尿病性黄斑水肿患者血清中lncRNA MALAT1水平及黄斑中央区厚度的影响

目的:探讨康柏西普对糖尿病性黄斑水肿(DME)患者血清lncRNA MALAT1水平、黄斑中央区厚度(CMT)及最佳矫正视力(BCVA)的影响,观察其治疗的有效性与安全性。方法:纳入DME患者300例300眼,均为单眼病变。按照随机数字表法进行分组:非注射组100例100眼,对照组100例100眼给予雷珠单抗治疗,研究组100例100眼给予康柏西普治疗。结果:治疗前与治疗后1、2、3mo测定患者BCVA、血清lncRNA MALAT1水平及CMT,同时对比临床疗效,并对患者进行随访,记录不良反应发生情况。非注射组患者的BCVA(LogMAR)、血清lncRNA MALAT1水平与CMT均无明显变化(P>0.05)。对照组、研究组患者治疗后1、2、3mo的BCVA(LogMAR)与治疗前相比明显提高(均P<0.05),但研究组与对照组相比,差异无统计学意义。对照组患者治疗后1、2、3mo血清lncRNA MALAT1水平降低,研究组患者治疗后1、2、3mo血清lncRNA MALAT1水平降低更明显,研究组治疗后血清lncRNA MALAT1水平明显低于对照组(均P<0.05)。对照组患者治疗后1、2、3mo CMT降低,研究组患者治疗后1、2、3mo CMT降低更明显,研究组治疗后CMT明显低于对照组(均P<0.05)。研究组不良反应发生率(2.0%)明显低于对照组(11.0%)。结论:康柏西普能够显著降低DME患者血清lncRNA MALAT1水平,降低CMT、减轻黄斑水肿,改善视力,其治疗有效性与安全性明显优于雷珠单抗。

Clinical research on zoledronic acid in treatment of pain caused by bone metastasis of malignant tumors

Objective:To evaluate the efficacy and safety of zoledronic acid for the pain caused by metastatic tumor of bone.Methods:52 patients with metastatic tumor of bone were randomly divided into two groups.The zoledronic acid group received 4 mg zoledronic acid infusion for 30 minutes and the control group received 90 mg pamidronate infusion for 6 hours. Results:The effective rates in zoledronic acid group and control group were 73.08%and 69.23%respectively.No significant difference was observed between the two groups.The median pain relief onset at days 5 and 7,respectively,and no significant difference was observed.The ECOG scores on the 7th day after medication:the differences in the zoledronic acid group before and after medication and between the two groups were both significant(P<0.001 and P=0.0448).The adverse reac- tion was no significant difference between the two groups.Conclusion:Zoledronic acid is efficient and safe in the treatment of pain caused by metastatic tumor of bone and it has low adverse reaction rate and convenient shorter using time.

Oxaliplatin combined with S-1 capsule in the treatment of 62 cases with advanced gastric cancer

Objective： The aim of this study was to evaluate the efficacy and safety profile of DeFazio （S-l） combined with oxaliplatin against unresectable advanced or metastatic gastric cancer. Methods： Oxaliplatin was given intravenously at 130 mg/m2 for 2 h on dl and S-1 was administered bid. at 80 mg/m2/day on d1-14 followed by a 7-day rest during the 3-week schedule. Results： All 62 patients were assessed for efficacy and adverse events. The response and disease control rates were 47.3% and 80.8%, respectively. The median time to progression was 7.8 months, and the median overall survival was 11.6 months. The grade 3/4 adverse events were hematological toxicities, including neutropenia （11.3%）, thrombocytopenia （9.7%） and gastrointestinal reactions （6.5%）. Conclusion： The SOX regimen （oxaliplatin, 130 mg/m2 d l; S-1, 80 mg/m2/day, bid. d1-14, q3w） provide a favorable efficacy and safety profile in patients with advanced gastric cancer.

LITERATURE RESEARCH ON POINT INJECTION WITH CHINESE ANGELICA LIQUOR

Chinese Angelica is sweet and pungent in flavour and warm in property. It has the effect of tonifying blood and activating blood circulation and is frequently applied for such gynecological diseases as irregular menstruation and weak constitution after delivery. Therefore, Chinese Angelica has also the name of 'sacred medicament in gynecology'.

Management of femoral artery pseudoaneurysm due to addictive drug injection

Objective: To study surgical management for pati ents with femoral pseudoaneurysm resulting from addictive drug injection. Methods: Clinical data of 34 patients with femoral pseudoaneury sm resulting from addictive drug injection were retrospectively reviewed. Results: Thirteen patients underwent bypass graft (end to side) of external iliac artery and superficial femoral artery using expanded polytetr afluoroethylene (ePTFE). Three patients who had an autogenous saphenous vein gra ft in situs,one of whom was then performed an ePTFE graft when rupture and blee ding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved. Conclusions: Ligating femoral artery is an effective way to tre at femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificia l vessel graft is not applicable.

Impact of intravenous acetaminophen therapy on the necessity of cervical spine imaging in patients with cervical spine trauma

Objective：We evaluated a new hypothesis of acetaminophen therapy to reduce the necessity of imaging in patients with probable traumatic cervical spine injury.Methods：Patients with acute blunt trauma to the neck and just posterior midline cervical tenderness received acetaminophen （15 mg/kg） intravenously after cervical spine immobilization.Then,all the patients underwent plain radiography and computerized tomography of the cervical spine.The outcome measure was the presence of traumatic cervical spine injury.Sixty minutes after acetaminophen infusion,posterior midline cervical tendemess was reassessed.Results：Of 1 309 patients,41 had traumatic cervical spine injuries based on imaging.Sixty minutes after infusion,posterior midline cervical tenderness was eliminated in 1 041 patients,none of whom had abnormal imaging.Conclusion：Patients with cervical spine trauma do not need imaging if posterior midline cervical tendemess is eliminated after acetaminophen infusion.This analgesia could be considered as a diagnostic and therapeutic intervention.

Observations on Curative Effect of High-frequency Electric Sparkle and Point-injection Therapy on Knee Osteoarthritis

Objective: To observe the curative effect of high-frequency electric sparkle and point-injection therapy (HESPT) on knee osteoarthritis (KOA). Methods: Two hundred and five patients were randomly divided into a warming needle moxibustion group (68 cases), a HESPT group (68 cases) and a point-injection group (69 cases). In the warming needle moxibustion group, the main points of Xuehai (SP 10), Neixiyan (EX-LE4), Waixiyan (EX-LE5), Dubi (ST 35), Zusanli (ST 36) and Yanglingquan (GB 34), and the adjunct points of Yinlingquan (SP 9) and Sanyinjiao (SP 6), on the affected side, were chosen for stimulation. In the HESPT group, tenderness points, the main points of Liangqiu (ST 34), Xuehai (SP 10), Neixiyan (EX-LE4), Waixiyan (EX-LE5) and Zusanli (ST 36), and the adjunct points of Yinlingquan (SP 9), Weizhong (BL 40) and Chengshan (BL 57), were chosen. After proper manipulation, Corydalis decumbens Pers. liquid was injected into the points and a high-frequency electric sparkle was applied to stimulate the needles for 30 seconds. In the point-injection group, point injection was performed with the same method, but the patients did not receive electric stimulation. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the Lysholm Knee Score Scale (LKSS) and the ROM (Range of Motion) scale were used to evaluate the severity of KOA and the function of knee joints before treatment and 4 weeks after treatment. Finally, the Nimodipine method was used to assess the total curative effect. Results: After HESPT treatment, the scores for pain, morning stiffness and swelling were significantly lower (P<0.01) and LKSS index and ROM were much higher (P<0.01 and P<0.05 respectively) compared to the two other groups. The obviously effective rate and total effective rate were also significantly higher in the HESPT group than in the two other groups (P<0.01 or P<0.05). Conclusion: HESPT can improve joint function in KOA patients, and the curative effect is better than for warming needle moxibustion or point-injection only.

Qingkailing injection for the treatment of acute stroke: a systematic review and Meta-analysis

OBJECTIVE： To evaluate systematically the clinical efficacy and safety of Qingkailing （QKL） injection in the treatment of acute stroke. METHODS： Searches for randomized controlled trials into acute stroke treated with QKL injection were performed in the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wan fang Database, Chinese Biomedical Literature Database, PubMed and Cochrane Library, from January 1979 to March 2013. Two reviewers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a Meta-analysis was conducted with Review Manager 5.2 software. RESULTS： A total of 13 studies with 1110 participants were included. The quality of the studies was generally low. The Meta-analysis indicated that the combined use of QKL and Western Medicine was significantly superior to control group therapy in terms of the total effective rate. The relative risk （RR） in the acute cerebral hemorrhage （ACH） sub-group was 1.17 [95% confidence interval （CI） （1.08, 1.26）, P=0.0001]. In the acute cerebral infarction （ACI） sub-group, RR was 1.27 [9.5% CI （1.14, 1.42）, P〈0.0001], and in the ACH and ACI mixed sub-group, RR was 1.34 [95% CI （1.20,1.50）,P〈0.00001]. Additionally, QKL promoted the absorption of hematoma [mean difference （MD）= - 3.73, 95%0 （ - 4.48, - 2.98）, P〈0.000 01], decreased neurological damage in ACI [MD= - 5.60, 95% CI （ - 8.50, - 2.70）, P=0.0002] and ACH [MD= 4.08, 95% CI （ - 8.00, 0.16）, P=0.04], promoted the recovery of awareness [RR=1.56, 95% CI （1.09, 2.21）, P=0.01] and reduced the whole blood viscosity coefficient [MD=- 0.75, 95% CI （ - 1.47, - 0.03）, P=0.04]. There were no adverse drug reactions reported in the included studies. CONCLUSION＂ Based on this systematic review, QKL combined with conventional therapy was effective compared with control treatment. However, because the articles used in the study were not of high quality, further studies should be conducted into the efficacy and safety of QKL in treating acute stroke.

Study on Modified Shengmai Yin Injection for Prevention and Treatment of Brain Impairment in Endotoxin Shock Rats

Objective:To examine the effects of modified Shenmai Yin on invigorating vital energy, promoting blood flow, and protection against neural impairment in an endotoxin-induced shock rat model. Methods: Ninety-six SD rats were randomly divided into four groups: sham operation (saline 20 ml/kg), shock model (lipopolysaccharide, LPS, 8 mg/kg), Reformed Shengmai Yin (加味生脉饮 Pulse-activating Decoction) (LPS 8 mg/kg + reformed Shengmai Yin Injection 10 ml/kg), and dexamethasone (LPS 8 mg/kg + dexamethasone 5 mg/kg) groups. Each group was subdivided into 1 h, 2 h, 3 h, and 6 h time points for observation. The carotid artery was separated and connected with a biological functional system to monitor mean arterial pressure (MAP). Brain water levels, malonaldehyde (MDA) content, and superoxide dismutase (SOD) activity were also determined. Results: In the shock model group, MAP was progressively decreased after injection of LPS, brain water and MDA contents were increased, brain SOD activity was decreased, and capillary vessel edema in brain tissue was also observed. All these parameters were improved significantly in both treatment groups, although the effects were more marked with Shengmai Yin than with dexamethasone. Conclusion: Modified Shengmai Yin exhibits strong anti-shock and neuroprotective effects against Endotoxininduced shock.