Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery

BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.

Purification and Characterization of Hyaluronate Lyases Produced by Two Types of Bacteria

Hyaluronate lyases were obtained from two types of naturally isolated bacterial strains Paenibacillus yunnanensis and Paennarthrobacter nicotinovorans.PyHL(form P.yunnanensis)in the culture supernatant of the bacteria was purified by two steps of column chromatography.The enzyme showed the molecular mass of 74 kDa by SDS-PAGE and the maximal activity at pH 5.0,35℃.PyHL maximally degraded hyaluronate by an endo-type manner,and showed low degradation activity toward chondroitin sulfates.Dermatan sulfate was not the substrate.PnHL(from P.nicotinovorans)in the culture supernatant of the bacteria was purified by two steps of column chromatography.The enzyme showed the molecular mass of 70 kDa by SDS-PAGE and the maximal activity at pH 6.0,30℃.Genomic analysis of P.nicotinovorans on the bases of the internal amino acid sequences of PnHL.

A Comprehensive Review of Long-Term Safety and Effectiveness of FACILLE Modified Sodium Hyaluronate Gel for Injection over 3 Years

FACILLE modified sodium hyaluronate gel was designed to be used for nasolabial fold (NLF) correction. However, no study has investigated the long-term safety and effectiveness of FACILLE. Thus, a retrospective study of 14 aesthetic clinics in China was conducted. This was the first large-scale, postmarketing study on FACILLE to evaluate the occurrence of adverse events (AEs) and provide essential information on the satisfaction of patients with FACILLE injections. This study recruited participants aged >18 years. FACILLE was injected into the NLFs on both sides of each participant’s face. The primary endpoint for safety was systemic or severe AEs at an injection site. Effectiveness was assessed on the basis of the participants’ subjective perceptions and satisfaction levels. Safety and effectiveness data were collected on the day of injection and at 2 weeks and 1, 3, 6, 9, 12, 18, 24, 30 and 36 months postinjection. In total, 1552 participants were enrolled (mean age, 29.1 years), and most of them (96.5%) were women. The mean injection volume was 1.39 ± 0.658 mL, and the average number of injections was 2.4 ± 1.68. AEs were reported by 205 participants (13.2%). All AEs occurred at local injection sites. No systemic or severe AEs were observed. Local pain was the most frequently reported AE regardless of the number of injections or the injection volume. Only eight AE cases were correlated with FACILLE administration, with two cases involving local allergic reactions. The participants self-reported that they perceived the procedure to have an effectiveness of ≥90% within 6 months postinjection although this percentage decreased substantially after 9 months. Their satisfaction level was >90% within 1 month postinjection but decreased gradually after 3 months. Our results indicate that the long-term safety of FACILLE injection is adequate. The high self-reported perceived effectiveness and satisfaction levels indicate the considerable potential of FACILLE injections for correcting NLFs.

Efficacy and safety of 0.4 percent sodium hyaluronate for endoscopic submucosal dissection of gastric neoplasms

AIM:To evaluate the efficacy and safety of sodium hyaluronate solution(SH) in endoscopic submucosal dissection(ESD) of gastric neoplasms.METHODS:A prospective multicenter randomized,double blind,controlled trial was designed and utilized in this study.A total of 76 patients with 5-20 mm sized gastric neoplasms were enrolled at three academic hospitals in South Korea from June 2011 to October 2011.Patients were randomly assigned to the 0.4% sodium hyaluronate or control groups.All lesions underwent endoscopic ESD.ESD was performed with 0.4%SH and normal saline(NS) solution for submucosal injection.Efficacy was assessed using en bloc resection and the number of additional injections.Secondary evaluation variables were the volume of injection material,steepness of mucosal elevation,bleeding rate,procedural time and operator satisfaction.Finally,the safety was assessed by analyzing adverse events during the study.RESULTS:The usefulness rate in the 0.4%SH group and the controlled group had statistically significant difference under intention to treat(ITT) analysis(90.91% vs 61.11% P = 0.0041).Under per protocol(PP),the usefulness rate is statistically significant different(93.10% vs 61.76%,P = 0.0036).The difference in volume of the solution injected between 0.4%SH group and the controlled group and NS group was also statistically significant under intention to treat and per protocol analysis(ITT:0.03 ± 0.02 mL vs 0.06 ± 0.03 mL,P = 0.0003,PP:0.03 ± 0.02 mL vs 0.06 ± 0.03 mL,P = 0.0004).Satisfaction above the grade good was significantly higher in the SH group under intention to treat and per protocol analysis(ITT:90.91% vs 61.11%,P = 0.0041,PP = 93.11% vs 61.77%,P = 0.0022).Adverse events above grade 3 were not noticed in either group.All adverse events were treated and were judged as not associated with the submucosal injection solutions.CONCLUSION:0.4%SH solution is a safe and effective agent that doesn't cause any significant adverse events and is useful for submucosal injection during ESD.

Low concentration of sodium hyaluronate temporarily elevates the tear film lipid layer thickness in dry eye patients with lipid deficiency

AIM： To investigate the effects of different concentrations of artificial tears on lipid layer thickness （LLT） and blink rate （BR） in dry eye patients. METHODS： This study included 106 eyes of 58 patients with dry eye. The lipid deficiency type was defined as the LLT baseline 〈75 nm. The LLT and BR were measured at baseline and 1, 5 and 15min after the instillation of 0.1% or 0.3% sodium hyaluronate （SH） eye drops by using the LipiView ocular surface interferometer. RESULTS： In the lipid deficiency group, the LLT increased from baseline at 1rain post instillation. The LLT after the instillation of 0.1% SH was significantly higher than that after the instillation of 0.3% SH （P〈0.001）. The LLT returned to baseline at 15min post instillation of 0.1% SH and at 5min post instillation of 0.3% SH. In the non-lipid deficiency group, the LLT decreased from baseline at lmin and returned to baseline at 5rain for both treatments. The BRs were not significantly different at different time points for both treatments. CONCLUSION： SH eye drops induce a short-term increase in LLT of patients with lipid deficiency. A low concentration of artificial tears have a stronger effect than a high concentration of artificial tears on the increase in LLT. in comparison, SH eye drops induce a transient and slight decrease in LLT of patients without lipid deficiency. A low concentration of artificial tears might be better for patients with lipid deficiency.

In vitro effects of sodium hyaluronate on the proliferation and the apoptosis in chondrocytes from patients with Kashin-Beck disease and osteoarthritis

Objective：To identify the in vitro effects of sodium hyaluronate（HA） on the proliferation and the apoptosis of chondrocytes from patients with Kashin-Beck disease（KBD） and osteoarthritis（OA）. Methods：Samples of articular cartilages from KBD and OA patients, as well as healthy volunteers（6 subjects in each of the 3 groups） were dissected, digested with collagenase and the cells cultured in monolayers. Chondrocytes from each sample were assigned to an untreated group and two HA-treated groups： H0（no HA）, H100（HA, 0.1 g/L） and H500（HA, 0.5 g/L）. The first passage chondrocytes were used to observe proliferation using the MTT assay, and apoptosis by flow cytometry through Annexin V/PI staining. Results：HA promoted proliferation of chondrocytes in all the three groups, and.in KBD and OA groups, for cells cultured for 4 and 6 days, H500 significantly promoted the cell proliferation. The apoptotic rates of both KBD and OA group chondrocytes were in the order H500 〈 HA100 〈 H0. Conclusion：Sodium hyaluronate administration has a dosedependent in vitro effect to promote proliferation and inhibit apoptosis of chondrocytes from patients with KBD and OA.

Determination of sodium hyaluronate in pharmaceutical formulations by HPLC–UV

A liquid chromatography （HPLC） method with UV detection was developed for determination of sodium hyaluronate in pharmaceutical formulation. Sodium hyaluronate is a polymer of disaccharides, composed of D-glucuronic acid and D-N-acetylglucosamine, linked via alternating 13-1, 4 and D-l, 3 glycosidic bonds. Being a polymer compound it lacks a UV absorbing chromophore. In the absence of a UV absorbing chromophore and highly polar nature of compound, the analysis becomes a major challenge. To overcome these problems a novel method for the determination of sodium hyaluronate was developed and validated based on size exclusion liquid chromatography （SEC） with UV detection. An isocratic mobile phase consisting of buffer 0.05 M potassium dihydrogen phosphate, pH adjusted to 7.0 using potassium hydroxide （10%） was used. Chromatography was carried out at 25 ~C on a BioSep SEC $2000, 300 mm ~ 7.8 mm column. The detection was carded out using variable wavelength UV-vis detector set at 205 nm. The compounds were eluted isocratically at a steady flow rate of 1.0 mL/min. Sodium hyaluronate retention time was about 4.9 min with an asymmetry factor of 1.93. A calibration curve was obtained from 1 to 38 g/mL （r〉0.9998）. Within-day % RSD was 1.0 and between-day % RSD was 1.10. Specificity/selectivity experiments revealed the absence of interference from excipients, recovery from spiked samples for sodium hyaluronate was 99-102. The developed method was applied to the determination of sodium hyaluronate in pharmaceutical drug substance and product.

Determination of sodium hyaluronate with some basic bisphenylnaphthylmethane dyes by resonance Rayleigh scattering method

In an acetic acid–sodium acetate buffer solution of pH 3.6–6.8, a compound complex was formed between sodium hyaluronate (abbreviated as SH) and some basic bisphenylnaphthylmethane dyes, leading to a great enhancement of the intensity of resonance Rayleigh scattering (RRS) and giving a new RRS spectrum, with its maximum scattering peak near 280 nm. It was also found that the intensity of RRS was directly proportional to the concentration of SH near the range between 0 and 3.0 mg/L. Based on these facts, a sensitive method for the determination of SH has been established. The method had good selectivity, and has been used for the determination of total amounts of SH in samples with satisfactory results. For the NB–SH system, the detection limit of SH was down to 13.7 ng/mL.

Clinical effect of Rehabmtation Treating combined with Intra-Articular Injection of Sodium Hyaluronate for Exercise induced knee osteoarthritis

Objective: To study the clinical effect of rehabmtation treating combined with intra-articular injection of sodium hyaluronate for exercise induced knee osteoarthritis, and to research the function, biomechanics of knee joint, and inflammatory factor in articular cavity. Method:Selecting 120 patients with exercise induced knee osteoarthritis, then they were randomly divided into control group (n=60) and intervene group (n=60). The patients in the control group were given conventional rehabmtation treating, and the intervene group were given intra-articular injection of sodium hyaluronate on this basic, they were treated 4 weeks. Evaluating the function of knee joint;conduct isokinetic muscle strength test (determination of the angIllar velocity were 60°/S, 180°/S);test the ratio of muscle peak torque and four muscles centripetal centripetal peak torque and peak torque, work load of femoral knee joints after (simultaneous determination of the angular velocity were 60°/S);detect the inflammatory factor in the joint fluid. Results: After the treatment, clinical effect in intervene group was superior to that in control group,but had no statistical significance;after the treatment, the score of function of knee joint in the two groups were higher than before treatment, and had statistical significance, and the score of function of knee joint in the intervene group were higher than control group, and the difference had statistical significance;Angular velocity of 60°/S and 180°/S the two groups peak torque, work load and the H/Q values were significantly increased, the intervene group were higher than control group, and the difference had statistical significance;inflammatory factor in the two groups were significantly decreased, the intervene group were lower than control group, and the difference had statistical significance.Conclusions: On the basic of rehabmtation treating, the treatment of intra-articular injection of sodium hyaluronate can improve the function of knee joint through improving the knee muscle strength, the level of their participation in the activities of the biomechanics of knee joint, and the inflammatory factor in the joint fluid.

Effect of arthroscopic debridement combined with intra-articular sodium hyaluronate injection on the Wnt/β-catenin pathway in joint fluid of patients with knee osteoarthritis

Objective: To investigate the effect of arthroscopic debridement combined with intra-articular sodium hyaluronate injection on the Wnt/β-catenin pathway in joint fluid of patients with knee osteoarthritis. Methods: Patients undergoing arthroscopic debridement for knee osteoarthritis in the hospital between June 2014 and April 2017 were selected as the research subjects and randomly divided into the observation group who accepted arthroscopic debridement combined with intra-articular sodium hyaluronate injection and the control group who accepted arthroscopic debridement alone. The Wnt/β-catenin pathway molecules as well as downstream collagen metabolism molecules and bone metabolism molecules in the joint fluid were measured before surgery and 7 d after surgery. Results: 7 d after surgery, Wnt1, Wnt5a, Wnt7b, β-catenin, MMP1, MMP13, CTX-I, CTX-II, ADAMTS4, ADAMTS5, RANK, RANKL and TRACP5b mRNA expression in joint fluid of both groups of patients were higher than those before surgery whereas OPG and OC contents were lower than those before surgery, and Wnt1, Wnt5a, Wnt7b, β-catenin, MMP1, MMP13, CTX-I, CTX-II, ADAMTS4, ADAMTS5, RANK, RANKL and TRACP5b mRNA expression in joint fluid of observation group were significantly lower than those of control group whereas OPG and OC contents were significantly higher than those of control group. Conclusion: Arthroscopic debridement combined with intra-articular sodium hyaluronate injection can inhibit the collagen metabolism and bone metabolism disorder mediated by Wnt/β-catenin after surgery.

Hyaluronate Increases Polynucleotides Effect on Human Cultured Fibroblasts

The HA is present in almost all vertebrates and plays a critical role in tissue development and cell proliferation, it has been demonstrated to promote wound healing and involved in angiogenesis and inflammation. Also polynucleotydes (PN) have proved to promote the “in vitro” growth and activity of human fibroblasts and osteoblasts, to increase reparation on UVB damaged dermal fibroblasts and seems to promote proliferation of human pre-adipocytes. Several in vivo studies have demonstrated the PN effect also in vivo, inducing an increase of angiogenesis and healing process. In this paper we have evaluated the effect of a mixture of Polynucleotides (PN) and entire Hyaluronic Acid (HA) on cultured human fibroblasts by analyzing cell growth. Different mixture have been tested and it has been demonstrated that the presence of HA even at low concentration (1 mg/ml) determine an increase of PN activity up to 20%. Furthermore, the addition of HA 1 mg/ml to PN 100 μg/ml induces a cell growth rate comparable to that exerted by PN concentration of 12 μg/ml.

Anti-scarring effect of sodium hyaluronate at filtration pathway after filtering surgery in rabbits

AIM: To investigate the anti-scarring effect of sodium hyaluronate(HA) at filtration pathway after filtering surgery in a rabbit model.METHODS: Fifteen healthy adult New Zealand white rabbits were selected for trabeculectomy in both eyes. The right eyes were used as HA group with 0.1 m L HA injected into the anterior chamber at the end of the operation;the left eyes were used with 0.1 m L sodium lactate Ringer’s solution(RS) injected into the anterior chamber as RS group. Intraocular pressure(IOP), filtering blebs morphology, inflammatory reaction and complications were observed at the 7, 60, and 90 d after surgery.RESULTS: One day after surgery, the IOP of HA and RS groups were 12.75±1.92 and 10.50±1.59 mm Hg(P=0.005). At the 7;day postoperative, the filtering blebs of each group were functional type and TGF-β expression was significantly difference in both groups(0.10±0.01 vs 0.14±0.02, P=0.024). After 60 d of the operation, all filtering blebs were scarring and alpha-smooth muscle actin(α-SMA) expression was significantly difference in both groups(0.40±0.04 vs 0.35±0.02, P=0.032). α-SMA positive cells were mainly distributed in the junction of conjunctiva and sclera and around the blood vessels. The collagen volume fraction(CVF) of HA and RS group was(75.49±7.01)% and(79.93±5.35)%(P=0.044). On the 90;day after the operation, CVF was(82.57±5.19)% and(88.08±1.75)% in HA and RS groups(P=0.036). There was no α-SMA positive cell in HA group, while a few positive cells were observed in RS group(P=0.000).CONCLUSION: HA has effect of anti-scar and antiinflammation on filtration pathway after filtering surgery within 3 mo by inhibiting fibroblast proliferation and collagen deposition.

The effectiveness of local anesthetic and sodium hyaluronate injection for the posterior disc displacement: A case report

Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.

Perceived Efficacy of Vaginal Dryness Relief: A Comparative Clinical Study between <i>Sodium hyaluronate vaginal gel</i>¹<i>vs. Promestriene cream</i>²

In the study, we report the comparative efficacy of the sodium hyaluronate gel vaginal application and promestriene cream which were tested to treat the gynecological symptoms of people who suffered from vaginal dryness. Method: 35 patients applied sodium hyaluronate vaginal gel one time a day for a period of two times a week during three weeks and other 33 patients using promestriene cream applied it every day for a period of three weeks also. Results: No significant difference was observed between vaginal application of sodium hyaluronate gel and promestriene cream, regarding both, as regarding the dryness of the intimate mucosa (p = 0.786), the attribute of moisturizing properties to the intimate mucosa (p = 0.142), the comfort sensation (p = 0.528), and no significant difference was observed regarding the fragrance of the product (p = 0.088). Conclusion: The similar results between vaginal application of both products support the use of sodium hyaluronate vaginal gel (Lubrinat&reg;) in the initial approach of symptoms of vaginal dryness.

Meta-analysis of the traditional Chinese medicine fumigation combined with sodium hyaluronate in the treatment of knee osteoarthritis

Objective:To explore the meta-analysis of traditional Chinese medicine fumigation combined with sodium hyaluronate in the treatment of knee osteoarthritis.Methods: The database was originated from CNKI, Wanfang, Chongqing Weipu database, PubMed and so on. The deadline was April 2017. The database was searched with the keywords of'Chinese herbal fumigation','sodium hyaluronate' and'knee osteoarthritis'. Finally, 13 articles about the treatment of Chinese herbal fumigation combined with sodium hyaluronate were obtained. RCT literatures of knee osteoarthritis identified the outcome indicators as the effective rate and recovery rate. Lysholm's score was observed after treatment in both groups, and all the results were input into Review Manager 5.2 for analysis.Result: A total of 13 RCT literatures about the treatment of knee osteoarthritis with Chinese herbal fumigation and sodium hyaluronate were obtained. The control group was treated with sodium hyaluronate or anti-inflammatory drugs, totaling 619 cases. The study group was treated with sodium hyaluronate and Chinese herbal fumigation, totaling 649 cases. The combined effect of forest map OR=1.82, Z=5.00 (P<0.00001), 95% CI. (1.44, 2.30). Compared with sodium hyaluronate or anti-inflammatory drugs, fumigation with traditional Chinese medicine combined with sodium hyaluronate has obvious advantages in curing knee osteoarthritis. The combined effect of forest chart OR=5.55, Z=7.44 (P<0.00001), 95% CI (3.54, 8.73), indicating that compared with sodium hyaluronate or anti-inflammatory drugs, traditional Chinese medicine is used. Fumigation combined with sodium hyaluronate has obvious advantages in the treatment of knee osteoarthritis;forest map combined effect OR=12.11, Z=5.18 (P<0.00001), 95% CI (7.53, 16.68), indicating that compared with sodium hyaluronate or anti-inflammatory drugs, traditional Chinese medicine fumigation combined with sodium hyaluronate in the treatment of knee osteoarthritis can restore knee joint function. Advantages.Conclusion: Chinese herbal fumigation combined with sodium hyaluronate has obvious advantages in curing and effective rate of knee osteoarthritis, and can better restore knee joint function. Due to the lack of literature and low quality, the exact effect still needs to be confirmed by higher quality RCT literature.

Clinical effect of sodium hyaluronate joint cavity filling combined with exercise therapy on patients with post-traumatic knee arthritis

Objective:To research the sodium hyaluronate joint cavity filling combined with exercise therapy on the indicator of pain,motor function,and levels of inflammatory factors in joint fluid in patients with post-traumatic knee arthritis.Method Totally 100 patients(Department of Orthopaedics,The second Affiliated Hospital to Liaoning University of Chinese Medicine,2013.10-2018.8)with post-traumatic knee arthritis were selected,then they were divided into observation group(n=50)and control group(n=50).The control group was given glucosamine sulfate and sodium hyaluronate joint cavity filling,the observation group was given leg press with visual feedback,they were treated 4 weeks.Assessing the pain degree through visual analog scale(VAS),hospital for special surgery knee score(HSS)as the indicator of motor function,inflammatory factor(TNF-α,IL-6,and IL-8)in the joint fluid.Results The score of VAS were lower than pretherapy(P<0.05),the degree of VAS of observation group were lower than control group(P<0.05).The score of HSS were higher than pretherapy(P<0.05),the degree of VAS of observation group were higher than control group(P<0.05).The inflammatory factor(TNF-α,IL-6,and CRP)in the joint fluid were lower than pretherapy(P<0.05),and the observation group were lower than control group(P<0.05).Conclusions Giving sodium hyaluronate joint cavity filling combined with exercise therapy can improve the function of joint.

Prevention effect of medical self-crosslinking sodium hyaluronate gel on epidural scar adhesion after laminectomy

Objective:To analyze the effect and medical sclf-crosslinking sodium hyaluronate gel on epidural scar adhesion after laminectomy.Methods:A total of 24 New Zealand L5 laminectomy rabbits were randomly divided into four groups,group A as the control group without any treatment:group B covered by sodium hyaluronate gel;group C and group D covered by 0.5 and1.0 mL medical self-crosslinking sodium hyaluronate gel.All rabbits were scored at various time points after 2.4,6,8,12 weeks,then the formation of scar was observed.Results:In Groups B,C,D loose scar tissue occurred after 2 weeks of the operation,scar tissues were significantly less than that in group A,with mild inflammatory reaction.After 8 weeks,the scar tissues of group B were significantly more than that of groups C,D.After two weeks,group B,C were back to the preoperative level;After 4 weeks,group D was back to the preoperative level;After four weeks,the CSEP of group A was increased significantly,which was significantly higher than that in groups B,C,D.The motor function score of group A,group B and group C were the same as preoperative,but that in group D it was decreased significantly,and then it gradually recovered.After 4 weeks it kept a stable level.The motor function score of group A was decreased gradually after the operation,which kept a stable level after 4 weeks,the motor function score was significantly lower man that in groups B,C,D.Conclusions:Determination of somatosensory evoked potentials is sensitive indicator of spinal cord injury;Application of medical selfcrosslinking sodium hyaluronate gel is effective on epidural scar adhesion after laminectomy.

Treatment of Hip Trochanteric Bursitis Using Hyaluronate Injections

Trochanteric bursitis is a common cause of musculoskeletal pain and often requires medical intervention and should be distinguished from sciatica and irradiating pain of pelvic and spinal origin. Previously, the etiology of the trochanteric pain syndrome was thought to be caused by inflammation. The current study was performed in order to assess the efficacy of trochanteric injections. Methods: 158 patients were treated for trochanteric bursitis (132 females/26 males, range 22 - 88 years). 59b were treated with corticosteroid injection, 60 with hyaluronate and 39 were injected using a combination of both. Patients were followed by the HOOS score for a minimum of 12 months. Results: Pre-operative HOOS scores were similar in all groups. Following injection, the HOOS score increased from 27 ± 4 to 66 ± 2 after six months and 77 ± 4 after a year. At 12-month follow-up, the average score of patients treated by corticosteroids injection was 44 ± 7 compared with 62 ± 8 for the hyaluronate injected group and 64 ± 6 for the combination injection group. Discussion: It appears that injection therapy is highly efficacious for treating trochanteric bursitis. The effect of hyaluronate or hyaluronate and steroid combination appears to be longer lasting than that of steroid alone.

Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis:a systematic review and Meta-analysis

OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,and SinoMed were searched from inception to July 2020.The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews.The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis.The heterogeneity among the articles was evaluated using I2.RESULTS:A total of 17 studies,comprising 2000 individuals,were included in this Meta-analysis.The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA.Statistical analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),P<0.01].Statistical analysis of visual analog scale showed that[standardized mean difference(SMD)=-2.84,95%CI(-4.01,-1.66),P<0.01].Western Ontario and McMaster University osteoarthritis index statistical analysis showed that[SMD=-1.57,95%CI(-2.52,-0.61),P<0.01].Lysholm score statistical analysis showed that[SMD=1.71,95%CI(0.98,2.44),P<0.01].In addition,only minor side effects,such as redness and swelling of the skin,were observed.CONCLUSIONS:Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with KOA.However,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.

Effect of Articular Cavity Injection Combined with Bite Splint Treatment on Anterior Disc Displacement Without Reduction

Objective:To observe the clinical effect of articular cavity injection combined with bite splint therapy for the treatment of anterior disc displacement without reduction(ADDWoR).Methods:The research subjects for this study were 30 patients with ADDWoR treated in the temporomandibular joint specialist outpatient clinic from November 2018 to November 2019,with a disease duration of 1 to 6 months.The treatment group was treated with an articular cavity injection of sodium hyaluronate+bite splint.The control group was treated with a simple articular cavity injection of sodium hyaluronate.The two groups were followed up once every 2 weeks to evaluate the treatment effect and observe the clinical efficacy of the two groups.Statistical analysis was carried out using SPSS 24.0.t-test and general linear regression analysis were carried out to compare the data of both groups,andχ^(2)-test and binary logistic regression analysis were performed for pain index comparison.Results:There was no significant difference in terms of the efficacy of the treatment received by both groups.The mouth opening and joint pain of patients in both groups were significantly improved after treatment(P<0.001).Conclusion:Articular cavity injection of sodium hyaluronate and occlusal splint therapy are both effective and safe methods for treating ADDWoR.