浅谈有机高分子材料老化试验

阐述有机高分子材料老化的机理,分析影响有机高分子材料老化的内外部因素,结合实际阐述各种老化实验方法。

浅谈有机高分子材料老化试验

阐述有机高分子材料老化的机理,分析影响有机高分子材料老化的内外部因素,结合实际阐述各种老化实验方法。

五种不同类型的激光对人主动脉及其斑块的作用

本研究比较了准分子激光,连续及脉冲YAG激光声光调Q倍频YAG激光和钬铒铥(αβ-YLF)激光照射人尸体主动脉及其斑块的作用。结果表明:五种激光均可汽化主动脉壁(包括正常及斑块),汽化凹坑深度随激光能量的增加而加深。在相同激光能量下,汽化斑块的凹坑深度大于汽化主动脉壁的凹坑深度。其中,声光调Q倍频YAG激光,αβ-YLF激光穿透力较差,而准分子激光,连续及脉冲YAG激光穿透力较强。形态学观察发现,连续YAG激光汽化组织产生凹坑边缘不整齐,伴有明显热损伤。αβ-YLF激光次之,而准分子激光汽化凹坑边缘整齐,几乎不伴热损伤。准分子激光有可能成为激光血管成形术的较理想的激光源。

Neoadjuvant vs adjuvant pelvic radiotherapy for locally advanced rectal cancer: Which is superior?

The treatment of locally advanced rectal cancer including timing and dosage of radiotherapy, degree of sphincter preservation with neoadjuvant radiotherapy, and short and long term effects of radiotherapy are controversial topics. The MEDLINE, Cochrane Library databases, and meeting proceedings from the American Society of Clinical Oncology, were searched for reports of randomized controlled trials and meta-analyses comparing neoadjuvant and adjuvant radiotherapy with surgery to surgery alone for rectal cancer. Neoadjuvant radiotherapy shows superior results in terms of local control compared to adjuvant radiotherapy. Neither adjuvant or neoadjuvant radiotherapy impacts overall survival. Short course versus long course neoadjuvant radiotherapy remains controversial. There is insufficient data to conclude that neoadjuvant therapy improves rates of sphincter preserving surgery. Radiation significantly impacts anorectal and sexual function and includes both acute and long term toxicity. Data demonstrate that neoadjuvant radiation causes less toxicity compared to adjuvant radiotherapy, and specifically short course neoadjuvant radiation results in less toxicity than long course neoadjuvant radiation. Neoadjuvant radiotherapy is the preferred modality for administering radiation in locally advanced rectal cancer. There are significant side effects from radiation, including anorectal and sexual dysfunction, which may be less with short course neoadjuvant radiation.

Radiation therapy concurrent with weekly cisplatin therapy for loco-regionally advanced nasopharyngeal carcinoma:outcomes of a clinical trial

Objective:The purpose of this study was to define the maximum tolerated dose(MTD) by describing the doselimiting toxicity(DLT) of weekly cisplatin concurrently with conventional plus 3-dimensional conformal radiotherapy(CT + 3DCRT) in patients with loco-regionally advanced nasopharyngeal carcinoma(NPC).Methods:Patients with loco-regionally advanced NPC(III/IVa stage) were enrolled into a dose-escalating study.Toxicity was graded according to Common Terminology Criteria for Adverse Events version 3.0(CTCAE v3.0).MTD was defined when 2 of 6 patients developed DLT.The starting dose of cisplatin was 15 mg/m2/w,with a subsequent dose escalation of 5 mg/m2/w in cohorts of 3 new patients.CT + 3DCRT was given to the nasopharynx and the upper neck;the lower neck was treated by a single anterior field irradiation.The prescription dose was 70-80 Gy by 35-40 fractions to the nasopharynx gross tumor,and 66-70 Gy by 33-35 fractions to the positive neck lymph nodes.Results:From Jun.2008 to Sep.2009,24 patients received complete chemoradiotherapy,and all of them were eligible for toxicity evaluation.On the first five dose levels of 15 mg/m2/w and 35 mg/m2/w,no patient experienced DLT.On the next dose level of 40 mg/m2/w,1 patient experienced DLT of grade 3 myelosuppression for 1.4 weeks,and among the additional 3 patients,no one developed DLT.On the seventh dose level of 45 mg/m2/w,all the patients developed grade 3 myelosuppression for more than 1 weeks,and the dose-escalating trial stopped.The 23(95.8%) patients achieved clinical complete remission(CR) in the local site;22(91.7%) achieved CR in the regional site,and all patients got CR 3 months later.After a median follow-up of 16.4 months,1 patient developed liver metastases 2 months later,1 patient developed bone metastases 10 months later and 22 kept disease-free survival.Conclusion:The MTD of cisplatin weekly with concurrent CT + 3DCRT for local advanced NPC is 40 mg/m2/w,with myelosuppression as DLT.

Irradiation-induced EMT is associated with activation of TGF-β and restriction of BMP signaling in esophageal cancer cells

Objective: Irradiation may enhance migration and/or invasiveness of cancer cells in vitro and in vivo, the mechanism of which may be associated with epithelial-mesenchymal transition (EMT). The present study explored the mechanisms of EMT induced by irradiation in esophageal cancer cells. Methods: Human esophageal cancer cell line EC109 was treated with increased doses of irradiation (0 Gy, 20 Gy, 40 Gy and 60 Gy). Cell morphology was observed. Expressions of E-cadherin and vimentin were determined by immunofluorescence assay or western blot. Secretion of transforming growth factor-β1 (TGF-β1) by cells was determined by enzyme-linked immunosorbent assay (ELISA), and the expressions of Smad2/3 and phosphorated Smad2 (p-Smad2) were also examined by Western blot. The mRNA expressions of BMP-4, a bone morphogenetic protein (BMP) ligand, and two secreted BMP antagonists (Chordin and Gremlin), were detected with reverse transcription-polymerase chain reaction (RT-PCR). Cell migratory capacity was evaluated. Results: Irradiation induced EMT in EC109 cells in a dose-dependent manner as evidenced by morphological changes, decreased expression of E-cadherin and increased expression of vimentin, and increased cell motility. The secretion of TGF-β1 and expression of p-Smad2 were gradually increased in an irradiation dose-dependent manner, but the Smad2/3 protein levels remained stable. The mRNA expression of BMP-4 was gradually down-regulated, but the expressions of Chordin and Gremlin were gradually up-regulated in cells treated with increased doses of irradiation. Conclusion: Irradiation can induce EMT in esophageal cancer cells in a dose-dependent manner, and the mechanism may be associated with activation of TGF-β and restriction of BMP signaling.

Role of intravenously administered hyoscine butyl bromide in retrograde terminal ileoscopy: A randomized, double-blinded, placebo-controlled trial

AIM： To evaluated the role of hyoscine butyl bromide in facilitating retrograde ileoscopy. METHODS： Retrograde terminal ileoscopy was attempted in 200 consecutive patients undergoing colonoscopy. After intubation of the cecum and visualization of the ileocecal valve, butyl bromide injection or normal saline was given intravenously to the patients in a double blind random fashion. The pulse rate and oxygen saturation were measured continuously. After completion of the procedure, endoscopists were then asked to score the ease of intubation and the ease of visualization of the terminal ileum on a visual scale of 1 to 10. The patients were also asked to score the pain after receiving hyoscine butyl bromide injection on a score of 1 to 10. RESULTS： Terminal ileoscopy could be performed in 188 patients. The mean （SD） visual analogue score for the ease of intubation of the cecum was 7.4 （0.65） in the injection group and 5.9 （0.8） in the placebo group （P 〈 0.001）. The mean （SD） length of ileum visualized in the injection group was 14.4 （3.3） cm and 10.4 （2.7） cm in the placebo group （P 〈 0.001）. The mean （SD） visual analogue score for ease of visualization of the terminal ileum was 7.5 （0.69） in the injection group and 5.9 （0.7） in the placebo group （P 〈 0.001）. The pain score experienced by the patients was 6.5 （0.7） in the injection group and 6.7 （0.69） in the placebo group （P 〈 0.008）. Although the pulse rate increased significantly in patients receiving the drug, no statistically significant difference was noted in the oxygen saturation between the two groups either before or after administration of the drug. No complications were observed in either of the groups. CONCLUSION： Hyoscine butyl bromide injection is a useful adjunct in helping the intubation and visualization of terminal ileum during colonoscopy.

Advance of prophylactic cranial irradiation in lung cancer

Brain metastases in patients with lung cancer are a devastating problem with profound impact on survival. Prophylactic cranial irradiation has been discussed as an option to reduce the risk of brain metastases. This report provides an extensive review of the current evidence from non-randomized and randomized trials regarding the use of prophylactic cranial irradiation in lung cancer.

Value of FDG PET/CT in the Management of Mesothelioma

The aim of this study is to compare and discuss the efficacy of FDG PET/CT （fludeoxyglucose positron emission tomography/computated tomography） in the diagnosis, staging, prognosis, pre-therapeutic planning, therapeutic assessment and detecting recurrence of mesothelioma. Following method has been used： （1） Search setting on PubMed （by priority）： meta-analysis, randomized controlled trial, other study types; （2） The key words： ＂FDG PET/CT＂, ＂mesothelioma＂, ＂diagnosis＂, ＂staging＂, ＂prognosis＂, ＂therapeutic＂, ＂assessment＂ and ＂recurrences＂; （3） Review the literature that discusses the imaging modalities in the management of mesothelioma; （4） Create an evidence table; （5） Compare and discuss the different modalities and their sensitivity and specificity in managing mesothelioma; （6） Construct the passage reviewing the articles chosen. There is evidence that suggests that FDG PET/CT is superior to most other modalities in the diagnosis, staging, prognosis, pre-therapeutic planning, therapeutic assessment and detecting recurrence of mesothelioma. There are some close contenders like PET scan by itself as a modality to detect mesothelioma. However, due to the lack of anatomical presentation, there were many occurrences of misdiagnosis. FDG PET/CT, which superimposes functional imaging over the anatomical mapping, yields a more accurate presentation ofmesothelioma. The nature of this hybrid imaging enables diagnosis and management to be carried-out in a minimally invasive manner. PET/CT to a great extent has tranformed the way we diagnose neoplastic occurences heretofore. By amalgamating anatomic localization to functional imaging, this hybrid modality yields valuable information that was remotely attainable before. Although there are a few flaws to PET/CT that have been discussed in some studies, there is an apparent potential to this modality that is waiting to be uncovered. Evidently, PET/CT is highly effective in differentiating benign and malignant pleural lesion. Likewise, it is substantially useful in the management of mesothelioma particularly in the diagnosis, staging, prognosis, treatment, monitoring and detecting recurrences. With PET/CT having such adequacy in managing mesothelioma, it is imperative to acknowledge and further investigate this modality as a central tool in the management of the latter for the exclusive benefit of the patient.

Multicenter randomly controlled trial on acupoint injection therapy with Chinese herbal medicines for oculomotor paralysis

Objective To evaluate the clinical effect of acupoint injection therapy for paralysis of oculomotor nerve with Chinese herbal medicines. Methods A total number of 456 patients from 3 centers with paralysis of oculomotor nerve were randomly divided into an acupoint injection group and a control group with 228 cases each. Patients in the acupoint injection group were treated with injection of Chinese herbal medicines to Jingming （晴明 BL 1）, Yangbai （阳白GB 14}, Sibai （四白 ST 24 Tongziliao （瞳子髎 GB I） on the affected side, and Ganshu （肝俞 BL 18） on both sides, Compound Angelica Injection was the main drug, and the corresponding acupoints and other injection drugs were also used according to differentiation of syndrome. Patients in the control group were treated with common western medicine. The treatment was given once a day, 10 times constituted one course with 3 days of interval. After 3 courses, the effect was assessed. TCM syndrome score, eyeball movement degree, the sizes of oculi rimae and pupil of the two groups were recorded before and after treatment. Results The effective rate of acupoint injection group was 91.7% （209/228）, and that of the control group was 73.6% （168/228）. There was statistical significance in comparing the difference between the two groups （P〈0.05）. TCM syndrome scores of the two groups after the treatment became less obviously than those before the treatment （P〈0.01, P〈0.05）, the score of acupoint injection group was more reduced than that of the control group （P〈0.05）. Eyeball movement degree and oculi rimae were enlarged and the pupil reduced in the affected eye in both groups after the treatment Call P〈0.05）. The musculus rectus medialis for the eyeball movement in the acupoint injection group was more improved than that of the control group, and the oculi rimae was bigger in the acupoint injection group than that in the control group （both P〈0.05）. Conclusion Acupoint injection therapy with Chinese herbal medicines has assured effect on the treatment of oculomotor paralysis.

Electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate:a randomized controlled trial

Objective To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.Methods The patients confirmed to the enrolled criteria were randomly divided into an observation group（n=31） and a control group（n=30）.In the observation group,electroacupuncture was applied to Sìbái（四白 ST 2）,Xiàguān（下关 ST 7）,Hégǔ（合谷 LI 4） and Zhīgōu（支沟 TE 6） on the left side for the anesthesia and the routine local anesthesia was done on the right side.In the control group,the routine local anesthesia was adopted on both sides.The feelings of pain,circulatory index and operation effect were observed and compared between the two groups.Results During radiofrequency ablation,the pain grades of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group（all P〈0.05）.In the observation group,the pain grade on the left side was lower than that on the right side（P〈0.05）,and the systolic blood pressure and the heart rate were lower than those in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side,respectively（all P〈0.05）.There was no significant difference in operation effect between the two groups.Conclusion Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for hypertrophic inferior turbinate,and would be helpful to prevent cyclic fluctuation during the operation at the same time.

Efficacy of Chaihu Jisang decoction on post-infection cough and its effect on cough reflex sensitivity

OBJECTIVE:To investigate the efficacy of Chaihu Ji Sang Decoction(CJSD),(a modification of Xiao Chaihu Tang(Minor Decoction of Bupleurum) was evaluated in patients with post-infection cough(PIC).Its effect on cough reflex sensitivity(CRS) was also described.METHODS:One hundred and eighteen patients with PIC were enrolled and randomly divided into an experimental group and control group(54 patients in each group).The experimental group was given CJSD orally,and the control group was given cetirizine hydrochloride for 7 d.Cough symptom scores and TCM symptom scores were compared before and after treatment.Efficacy,cough onset time,recurrence,and adverse drug reactions were additionally evaluated.Finally,CRS was evaluated before and after treatment of PIC patients in the experimental group.RESULTS:Fifty-two patients in the experimental group and fifty control patients completed the study.Cough symptom scores and the TCM symptom scores of the two groups were significantly improved after treatment,however cough symptoms in the experimental group 1(0,2) were significantly lower than the control group 2(1,2) after treatment(P < 0.05).Similarly,TCM symptom scores 4(0,7) in the experimental group were significantly lower than the control group 6(3,12)(P < 0.01).Overall,the effective rate of the experimental treatment(84.60%) was significantly higher than that of the control treatment(68.00%)(P < 0.01).The onset time of efficacy of the experimental treatment was one day faster than the control treatment [2(2,3) d vs 3(2,3) d,P < 0.01].The relapse rate in the experimental group(9.09%) was lower than that of the control group(29.41%)(P < 0.05).39 PIC patients in the experimental group completed a capsaicin cough challenge test before treatment.The lgC2 and lg C5 of the experimental group prior to treatment was 1.19(0.59,1.49) and 1.80(1.49,2.10),respectively.The lgC2,lg C5 of the healthy control group was 1.49(0.89,2.40) and 2.70(2.40,3.00),respectively.The differences in lgC2 and lg C5 between experimental group and healthy groups were significant at this time point(both P < 0.01).After treatment,34 patients in the experimental group received re-examination.lg C5 increased from 1.80(1.49,2.10) to 2.10(1.49,3.00).CRS after treatment/re-examination was significantly lower than those of baseline in the experimental group(P < 0.05).CONCLUSION:CJSD could effectively improve the clinical symptoms of PIC patients,with demonstrable low recurrence and safety.CJSD also significantly decreased the CRS in patients with PIC.

Use of intravenous tranexamic acid in total knee arthroplasty： a meta-analysis of randomized controlled trials

Objective： The effect of tranexamic acid （TA） on patients receiving total knee arthroplasty （TKA） has been reported in many small clinical trials. But single trials are not sufficient enough to clarify the effectiveness and safety of TA. So, we carried out a meta-analysis of randomized controlled trials to investigate the efficacy and safety of the intravenous use of TA in TKA. Methods： Literatures were retrieved in Cochrane Library, OVID, PubMed, EMBASE, CNKI and Wanfang Data. All the related literatures were checked by two independent investigators and only the high quality randomized con- trolled trials were enrolled. Relevant data were analyzed using RevMan 5.1 to compare the difference of blood loss, transfusion and complications between TA group and con- trol group. Results： There were 353 related literatures and only 22 randomized controlled trials met the inclusion criteria. The use of TA in TKA significantly reduced total blood loss by a mean of 435.41 ml （95% C1300.62-570.21, P〈0.01）, post- operative blood loss by a mean of 406.69 ml （95% C1333.16- 480.22, P〈0.01）. TA also significantly lowered the transfu- sion rate （risk difference 0.30, 95% CI0.21-0.39, P〈0.01） and transfusion volume （mean difference 0.95 unit, 95% CI0.53- 1.37, P〈0.01）. The risks between TA group and control group in developing deep vein thrombosis and pulmonary embo- lism were not statistically significant. Conclusion： TA is beneficial for patients undergoing TKA, which can significantly reduce total blood loss, post- operative blood loss, transfusion rate, and transfusion volume. Meanwhile TA is recommended to reduce deep vein thrombosis and pulmonary embolism following TKA.

Xiyanping injection therapy for children with mild hand foot and mouth disease:a randomized controlled trial

OBJECTIVE: To evaluate the clinical effects of Xiyan-ping injection intervention in pediatric patients with mild hand foot and mouth disease(HFMD).METHODS: A total of 329 patients were stratified and block-randomized for symptomatic treatment of HFMD and assigned to one of the following groups: Western Medicine(group A, n = 103), Xiyanping injection(group B, n = 109), or Xiyanping injection and symptomatic treatment using Western Medicine(group C, n = 117). During the trial, fever,rash, ulcers of the mouth were observed among participants in each group before and after treatment, and conversion rates from mild to severe HFMD were measured.RESULTS: After 3-7 days' treatment, no significant differences in the conversion rates from mild to severe HFMD were observed among the three groups(P > 0.05). There was a significantly low number of patients with the onset time of antifebrile effect,vanished time of hand and foot rashes and cumulative time for the ulcers in the mouth vanished,among the three groups(P < 0.05, P < 0.01). The onset time of antifebrile effect of patients in groups B and C were markedly shorter compared with those in group A(P < 0.05, P < 0.01); there was no statically significant difference observed between groups B and C(P > 0.05). No significant differences were observed in the time for body temperature recovery among the three groups(P > 0.05). There were no significant differences in adverse effects among the three groups(P > 0.05).CONCLUSION: Xiyanping injection together with use of Western Medicine is most effective for symptomatic treatment of mild HFMD. No severe adverse reactions were observed.

Effect of Aidi injection plus chemotherapy on gastric carcinoma:a Meta-analysis of randomized controlled trials

OBJECTIVE: To conduct a Meta-analysis of studies on the effect of Aidi injectioncombined with chemotherapy versus chemotherapy alone in the treatment of gastric cancer(GC).METHODS: Nine electronic databases and six gray literature databases were comprehensively searcheduntil April 20,2013. Two reviewers independently selected and assessed included trialsaccording to the inclusion and exclusion criteria. The risk of bias tool from the Cochrane Handbook version 5.1.0was used to assess trial quality. All calculations were performed using Review Manager 5.0.RESULTS: Thirty-two studies including 1927 participants met the inclusion criteria,most of which were low quality. Compared with chemotherapy alone,Aidi injection plusthe same chemotherapy significantly improved the effective rate [OR = 1.52,95% CI(1.24,1.86),P < 0.0001],clinical beneficial rate [OR = 1.77,95% CI(1.33,2.36),P < 0.0001],and quality of life [OR = 3.02,95% CI(2.39,3.82),P <0.000 01]. There was a significant improvement in nausea and vomiting incidence [OR = 0.34,95%CI(0.24,0.47),P < 0.000 01],diarrhea [OR = 0.47,95%CI(0.33,0.69),P < 0.000 01],leukopenia( 3,0.51),P = 0.05],hemⅢ-ogⅣ)[OR = 0.34,95%CI(0.2lobin decrease(thromⅢ-boⅣ) [OR = 0.42,95%CI(0.18-1.00),P = 0.05],cytopenia(4],and Ⅲ-damⅣ) [OR = 0.46,95%CI(0.22,0.96),P = 0.0age to liver function [OR = 0.36,95%CI(0.24,0.54),P < 0.000 01].CONCLUSION: Aidi injection combined with chemotherapy significantly improved the clinical effect of chemotherapy,reducing the incidence of adverse events. Use of the CONSORT statement for randomized controlled trials is recommended for stricter reporting.

Clinical efficacy observation of comprehensive ying needling therapy for mumps

Objective： To compare the clinical efficacy difference between comprehensive ying needling therapy and intramuscular injection with ribavirin for mumps.Methods： One hundred patients with mumps were randomly divided into comprehensive ying needling therapy group（group A, 52 cases） and western medicine group（group B, 48 cases）, then 8 cases were eliminated and drop out from group A and 4 cases were eliminated and drop out from group B respectively. actual inclusion 44 cases in group A 44 cases in group B. Point bloodletting was performed at parotid gland（腮腺Sāixiàn） and Threeshang acupoints of the patients in group A for once every other day, treatment for 7 days was considered as 1 course of treatment, and 2 courses were needed. Intramuscular injection with ribavirin was given to the patients in group B for twice a day, treatment for 7 days was considered as 1 course, and 2 courses were needed. The parotid gland swelling score, fever score, orifice parotid duct swelling score, score of difficulty in opening mouth and the clinical efficacy of the patients in the two groups were compared before and after treatment.Results： The cured and markedly effective rate in group A was 90.9%（40/44）, which was superior to 68.2%in group B（30/44）（P〈0.05）. The symptom scores were all improved significantly in the two groups after treatment（all P〈0.05）, and the improvement in group A was superior to that in group B（all P〈0.05）.Conclusion： The curative effect of comprehensive ying needling therapy for treatment of mumps was superior to that of conventional western medicine therapy.