Effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures

Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods: A total of 72 patients with osteoporotic distal radial fractures who were treated in the hospital between September 2015 and January 2017 were collected and divided into control group (n=36) and observation group (n=36) according to the random number table method. Control group received routine external fixation, and observation group received mid-frequency pulse therapy combined with external fixation. The differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups. After 1 month of treatment, serum BGP, TAC and SOD levels of both groups of patients were higher than those before treatment whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those before treatment, and serum BGP, TAC and SOD levels of observation group were higher than those of control group whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those of control group.Conclusion: Mid-frequency pulse therapy combined with external fixation can promote fracture healing and reduce postoperative inflammatory response and oxidative stress response in patients with osteoporotic distal radial fracture.

Managing Vogt–Koyanagi–Harada disease during pregnancy with steroid pulse therapy:A case report

BACKGROUND High-dose steroid administration is a common initial therapeutic approach for Vogt–Koyanagi–Harada disease(VKH).Nonetheless,administering substantial doses of steroids to pregnant women necessitates meticulous consideration due to the potential impacts on the mother and fetus.We present a case wherein steroid pulse therapy was administered to a patient who developed VKH during the late stages of pregnancy.CASE SUMMARY The patient was a 26-year-old nulliparous woman.At 33 weeks and 1 day of her pregnancy,she experienced a decline in visual acuity and noticed metamorphopsia in her left eye.Examination revealed bilateral serous retinal detachment,leading to VKH diagnosis.A collaborative effort involving the departments of ophthalmology,internal medicine,and neonatology was initiated.Steroid pulse therapy was administered at 34 weeks and 1 day of pregnancy under hospital supervision.Complications,such as threatened preterm labor and gestational diabetes,emerged,necessitating the initiation of oral ritodrine hydrochloride and insulin therapy.Then,serous retinal detachment was resolved,and visual acuity was restored.Labor pains initiated 32 days post-initiation of steroid pulse therapy(at 38 weeks and 4 days of gestation),culminating in a normal delivery.Mother and newborn experienced an uneventful puerperal course and were discharged from the hospital on the 5th day following delivery.CONCLUSION VKH management in pregnancy requires multidisciplinary coordination,emphasizing collaboration with ophthalmologists and specialists in internal medicine and neonatology.

Novel intense pulsed light-photodynamic therapy strategy in the treatment of facial actinic keratoses concomitant with rosacea

Rosacea presents as transient or persistent erythema,papules,pustules,fAushing,and telangi-ectasia on the middle of the face,which has some clinical similarity with act inic keratosis(AK).These two conditions can coexist in the same patient.Dermoscopy and reflect ance confocal microscopy(RCM)could be useful methods for diagnosis and monitoring treatment efficacy.Novel intense pulsed light-photodynamic therapy(IPL-PDT)may have better tolerance and curative effect than traditional red-light 5-aminolevulinic acid photodynamic therapy(ALA-PDT).Herein,we present a case of facial AKs concomitant with rosacea where combination therapy of novel IPL-PDT and oral minocycline was effective in that AK lesions were eliminated and the patient's facial erythema and telangiectasia were significantly improved.

Does Low-Dose Intravenous Methylprednisolone Pulse Therapy Produce Unacceptable Adverse Effects in Children?

Background: Intravenous methylprednisolone pulse therapy has been used since the late 1960s for acute transplant rejection or severe renal involvement in systemic lupus erythematosus and primary glomerulonephritis. However, reports of serious adverse effects such as life-threatening cardiac arrhythmias and sudden death raise questions about its safety. Objective: To investigate the incidence of significant adverse effects associated with low-dose methylprednisolone pulse therapy (LDMPT) in pediatric patients. Methods: We retrospectively analyzed adverse effects during and after LDMPT in 68 patients (median age: 11.4 years;43% male) with various glomerular diseases who were admitted to Saitama Children’s Medical Center between April 2007 and December 2010. LDMPT consisted of pulse methylprednisolone (15-20 mg/kg;maximum 600 mg/d) for 3 consecutive days weekly for 2-3 weeks. Results: Although adverse effects occurred in 54 of 68 patients (79%), most were mild and transient. Transient glycosuria was noted in 46 patients (68%), hypertension in 6 (9%), elevated intraocular pressure in 6 (9%), hypokalemia in 5 (7%), and liver damage in 2 (3%). No late-onset adverse effects such as osteoporotic fractures, steroid diabetes mellitus, or short stature were observed. Conclusion: LDMPT appears to be relatively safe and well tolerated in children with various glomerular diseases.

Methylprednisolone Pulse Therapy in COVID-19 as the First Choice for Public Health: When Right Timing Breaks Controversies—Emergency Guide

Based on Russian and the Middle East corticosteroids trials in MERS-CoV, we performed methylprednisolone pulse therapy (MPT), resulting in a clinical trial still without result. Our previous cohort (not compared n = 18) showed 76% of MPT patients did not progress to orotracheal intubation as MTP blocked the cytokine storm, a lower result compared to Tehran’s study explained by performing MPT in any lung phase. The Middle East study had been carried out during the initial lung phase. We are in an international emergency. Considering previous protocols and clinical practice, we understand that MPT must be used in COVID-19, and the indication to avoid going to the hospital when the first symptoms appear should be changed urgently for the population with inflammatory comorbidities. This article aims to: 1) show the Iranian protocol to reduce deaths and intubations by COVID-19;2) present a possible approach to the patient COVID-19 with methylprednisolone pulse and strict criteria for orotracheal intubation to avoid hypoxemia;3) highlight that there is already a protocol that can be an international guideline-based on the Iranian work for the treatment of COVID-19;and 4) argue that corticosteroids are not controversial, but their use in a period outside the best timing period makes it controversial;and 5) emphasise the urgency of modifying the current protocol that postpones the visit of patients to the hospital in case of symptoms, since late hospital evaluation has been catastrophic for a world population.

Preliminary Colorimetric Assessment of Progressive Nonsegmental Vitiligo under Short-Term Intravenous Methylprednisolone Pulse Therapy

Although the administration of systemic steroid for nonsegmental vitiligo in the progressive stage is a recommended treatment according to guidelines, the clinical efficacy of this regimen has not been fully established. In this study, we evaluated the clinical efficacy of half-dose steroid treatment and stratified the evidence regarding its usefulness in progressive vitiligo patients. Half-dose steroid pulse therapy (500 mg/day of methylprednisolone for three sequential days) was administered intravenously three times monthly in five vitiligo patients. The visual changes in vitiligo lesions were evaluated on photographs and quantified using a spectrophotometer. As results, all patients completed three cycles of treatment without severe adverse events. Three of the five patients achieved disease arrest with decrease in white contrast. Therefore, short-term and halfdose steroid therapy is well tolerated and effective for achieving disease arrest in progressive nonsegmental vitiligo. The whiteness assessed by a spectrophotometer is possibly associated with therapeutic response to steroid therapy.

Fifty Cases of Chloasma Treated by Acupuncture plus Intensive Pulse Light Irradiation

Objective: To observe the clinical therapeutic effect of acupuncture plus intensive pulse light irradiation on chloasma. Methods: Ninety-six cases of chloasma were randomly divided into two groups, the control group of 46 cases treated by simple acupuncture and the treatment group of 50 cases treated by acupuncture and intensive pulse light irradiation. Results: The total effective rate was 89.1% and 98.0% in the control group and treatment group respectively, with a significant difference between the two groups (P<0.05). Conclusion: For chloasma, the effect of treatment with acupuncture plus intensive pulse light irradiation is superior to that with simple acupuncture.

ACUPUNCTURE AT NEIGUAN POINT FOR TREATMENT OF 106 CASES OF LOW PULSE PRESSURE SYNDROME

In spite of normal mean aterlal pressure,decrease of pulse pressure can induce a seriesof clinical symptoms,which is termed as low pulse pressure syndrorne.Acupuncture at bilateralNeiguan（PC 6）is Capable of raising systolic pressure, lowering diastolic pressure, increasing pulsepressure difference and eliminating corresponding symptoms.The effective rate was more than 92％in this observation.

Effects of pulse width and repetition rate of pulsed laser on kinetics and production of singlet oxygen luminescence

Pulsed and continuous-wave(CW)lasers have been widely used as the light sources for photodynamic therapy(PDT)treatment.Singlet oxygen(^(1)O_(2))is known to be a major cytotoxic agent in type-II PDT and can be directly detected by its near-infrared luminescence at 1270 nm.As compared to CW laser excitation,the effiects of pulse width and repetition rate of pulsed laser on the kinetics and production of^(1)O_(2)luminescence were quantitatively studied during photosensitization of Rose Bengal.Significant di®erence in kinetics of^(1)O_(2)luminescence was found under the excitation with various pulse widths of nanosecond,microsecond and CW irradiation with power of 20mW.The peak intensity and duration of^(1)O_(2)production varied with the pulse widths for pulsed laser excitation,while the^(1)O_(2)was generated continuously and its production reached a steady state with CW excitation.However,no significant di®erence(P>0:05)in integral^(1)O_(2)production was observed.The results suggest that the PDT efficacy using pulsed laser may be identical to the CW laser with the same wavelength and the same average°uence rate below a threshold in solution.

甲泼尼龙冲击治疗儿童肾脏风湿性疾病导致窦性心动过缓11例病例系列报告

背景国内缺乏甲泼尼龙冲击治疗儿童肾脏风湿性疾病导致窦性心动过缓(SB)的报道,发生SB后是否停止冲击治疗尚无定论。目的 总结甲泼尼龙冲击治疗儿童肾脏风湿性疾病时导致SB的临床特征。设计病例系列报告。方法 纳入2018年1月1日至2024年4月1日在苏州大学附属儿童医院肾脏免疫科住院、使用甲泼尼龙冲击治疗,治疗期间任意一次测量心率<60次/分且经心电图证实为SB的连续病例。截取患儿的临床表现、辅助检查以及转归情况。主要结局指标甲泼尼龙冲击治疗后发生SB的临床特征。结果 11例患儿纳入本文分析,女7例,男4例,平均年龄(11.3±2.5)岁,其中系统性红斑狼疮合并巨噬细胞活化综合征(MAS)3例,IgA血管炎相关性肾炎、幼年特发性关节炎合并MAS、皮肌炎合并MAS各2例,ANCA相关性血管炎和C3肾小球肾炎各1例。平均基础心率(88±4)次/分。甲泼尼龙冲击治疗的平均剂量为(10.7±3.0) mg·kg~(-1)·d~(-1),冲击治疗时间3~5(4.3±0.9)d。SB发生时间为第1剂甲泼尼龙冲击治疗后1~3(1.8±0.8)d,最低心率48~58(53±4)次/分,心率下降幅度32.6%~44.6%(40.0%±3.7%)。出现SB时血气分析、电解质检查、心脏超声和甲状腺功能均未见异常。均未予抗心律失常治疗,最后1剂甲泼尼龙冲击治疗至恢复到基础心率的时间为4~8(6.1±1.1)d。治疗期间均未出现头晕、胸闷、心悸等心血管系统症状,随访(2.4±2.1)年,均未发现心血管系统异常。结论 甲泼尼龙冲击治疗引起SB时患儿无不适症状,易被忽视,一般无需特殊治疗,可在密切监测下继续完成冲击疗程,心率多在冲击治疗结束后1周左右恢复正常。

不同剂量糖皮质激素冲击治疗风湿病患者的临床疗效分析

目的分析不同剂量糖皮质激素冲击治疗风湿病的临床疗效。方法80例风湿病患者,采取随机形式分为对照组和研究组,每组40例。对照组接受小剂量甲泼尼龙琥珀酸钠治疗,研究组接受大剂量甲泼尼龙琥珀酸钠治疗。比较两组患者治疗效果、不良反应发生情况。结果研究组疾病治疗总有效率90.0%高于对照组的60.0%,对比存在显著差异(P<0.05)。研究组治疗期间不良反应发生率为37.5%,与对照组的25.0%对比不存在显著差异(P>0.05)。结论临床中为风湿病患者提供大剂量糖皮质激素进行冲击治疗,能够提高疾病临床疗效,且不会引发严重不良反应。

超声引导下隐神经脉冲射频治疗膝骨关节炎的临床研究

目的研究超声引导下隐神经脉冲射频(PRF)治疗膝骨性关节炎(KOA)的疗效及安全性。方法自2021年3月到2023年10月随访KOA患者289例,按照不同治疗方法分为PRF组(A组,n=142)和保守治疗组(B组,n=147),记录两组治疗前和治疗后1周、1个月、3个月、6个月疼痛程度(VAS)、膝关节功能(OKS)和睡眠质量(AIS),并记录并发症的发生情况,进行组间比较。结果两组在治疗后,VAS、OKS、AIS评分均较治疗前下降(P<0.001)。且A组评分在术后6个月内均呈现逐渐下降趋势,而B组评分6个月内整体呈现上升趋势。A组的VAS、OKS评分从术后1周到6个月均显著低于B组(P<0.001);A组AIS评分从术后1月到术后6个月远小于B组(P<0.001)。两组间并发症的发生率无统计学差异(P=0.236)。结论超声引导下隐神经PRF术可以更好地降低KOA患者的疼痛、提高膝关节活动能力及改善睡眠,效果优于保守治疗。

低频脉冲电疗配合无痛运动疗法在PVP治疗OVCF中的应用

目的:探究低频脉冲电疗配合无痛运动疗法在经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)患者中的应用价值。方法:收集在医院骨科接受PVP治疗的70例OVCF患者,据随机信封法划分为观察组(35例)与对照组(35例)。对照组患者实施常规围术期康复干预方案,观察组患者基于对照组常规干预方案上实施低频脉冲电疗配合无痛运动疗法。持续干预4周,比较两组干预后腰椎活动度,干预前后疼痛NRS评分、腰椎功能ODI评分、日常生活活动能力ADL评分、生活质量评分;比较两组干预总体优良率。结果:干预后,观察组患者左右弯曲、前屈及后伸、左右旋转的腰椎活动度均高于对照组(P<0.05),两组患者NRS评分及ODI评分均较治疗前降低,但观察组降低幅度大于对照组(P<0.05);两组患者ADL评分及生活质量评分均较治疗前升高,但观察组改善幅度大于对照组(P<0.05);观察组患者干预总体优良率明显高于对照组(P<0.05)。结论:骨质疏松压缩骨折患者在PVP治疗的术后采用低频脉冲电疗配合无痛运动疗法进行康复干预的效果显著,且能明显减轻腰椎疼痛感,改善腰椎功能,提升日常生活活动能力,辅助改善患者预后生活质量,值得推广。

一种用于尿道瘢痕防治动物实验的超声探头设计

目的 尿道瘢痕是患者尿道手术后常见的并发症之一,并且难以通过手术治疗方法清除。低强度脉冲超声(low intensity pulse ultrasound,LIPUS)在抑制纤维化,抑制炎症方面有十分突出的表现,为超声防治尿道瘢痕提供了理论的可能性。尽管如此,目前并没有对超声用于尿道瘢痕的防治作用的报道,另外有关超声抑制纤维化、抑制炎症的作用机制也仍需要进一步的研究。本文针对新西兰雄兔尿道重建模型设计了一种超声探头,用于LIPUS抑制尿道瘢痕疗效和作用机制的动物实验研究。方法 根据兔阴茎的尺寸与形状设计探头结构,通过有限元仿真预测探头声场,用3D打印技术制造原型机。最后对探头声场进行测试,并且用于动物实验验证其实用性。结果 探头超声频率为2 MHz,治疗腔长度44 mm,直径8 mm。治疗腔沿长度方向上有3个紧邻的治疗区,每个治疗区的半功率长度约6 mm,治疗区内的I_(sata)(时间平均空间平均声强)可通过前端驱动器电源电压进行调节,当电源电压为30 V时,I_(sata)大于0.87 W/cm^(2)。结论 本文设计的超声探头体积小、重量轻、声场均匀,可以对动物尿道实施稳定有效的超声照射,为超声治疗尿道瘢痕动物实验提供了一种有用的工具。

中医定向透药疗法和中频脉冲电刺激治疗偏瘫肩痛的疗效差异分析

目的 分析偏瘫肩痛患者实施中医定向透药与中频脉冲电刺激治疗的效果。方法 随机选取潍坊市中医院于2022年11月—2023年11月收治的60例偏瘫肩痛患者为研究对象,掷骰子分组为透药组与刺激组,各30例。透药组行中医定向透药治疗,刺激组行中频脉冲电刺激治疗。比较两组疼痛情况、肩关节活动度、肢体功能情况及有效率。结果 治疗后,透药组疼痛评分低于刺激组,肩关节活动度高于刺激组,上肢功能及上肢自理能力优于刺激组,差异有统计学意义(P均<0.05)。透药组治疗总有效率为96.67%,高于刺激组的76.67%,差异有统计学意义(χ^(2)=5.192,P<0.05)。结论 中医定向透药疗法可大幅减轻肩痛问题,拓展肩关节活动度,提升肩关节功能,有效率高,相比中频脉冲电刺激疗效更好。

“乎井术”针刺疗法治疗慢性非萎缩性胃炎临床研究

目的:观察长桑君脉法“乎井术”针刺疗法对缓解慢性非萎缩性胃炎临床症状的临床疗效。方法:回顾分析2020年6月—2022年10月到广州中医药大学顺德医院顺峰山门诊和三门诊就诊,且治疗方案采用了长桑君脉法“乎井术”针刺疗法的慢性非萎缩性胃炎患者资料。比较患者治疗前后的中医证候积分,并统计临床疗效、症状缓解时间及不良反应。结果:治疗后患者腹痛、腹胀、胸胁胀痛、烧心、呃逆、恶心等中医证候积分均降低(P<0.05)。临床治疗总有效率91.71%。不良反应发生率0.55%。治疗后患者各不适症状均在2~4 min左右可得到缓解。结论:“乎井术”针刺治疗能迅速缓解患者临床症状,解除患者痛苦,操作简便,安全有效。

PPV和PVI在胃肠肿瘤手术目标导向液体治疗中的疗效对比研究

目的比较脉压变异率(Pulse pressure variation,PPV)与脉搏灌注变异指数(Pleth variability index,PVI)在胃肠肿瘤手术目标导向液体治疗(Goal-directedfluidtherapy,GDFT)中的疗效。方法选取2021年9月-2024年2月在延安市人民医院麻醉科全麻下行腹腔镜胃肠道肿瘤手术的患者106例,采用随机数字表法分为PPV组(n=53)和PVI组(n=53)。两组患者术中背景输液情况为复方氯化钠3 mL·kg^(-1)·h^(-1)。PPV组若PPV≥11%持续1 min,则按照15 mL·kg^(-1)·h^(-1)的速度输注晶体液,若超过15 min则继续胶体液输注,直到PPV<11%持续1 min,恢复背景输液速度。PVI组若PVI≥11%持续1 min,则按照15 mL·kg^(-1)·h^(-1)的速度输注晶体液,若超过15 min则继续胶体液输注,直到PPV<11%持续1 min,恢复背景输液速度。记录患者术中低血压时间加权平均值(Time weighted average of Hypotension,TWAH)、输液情况、尿量;记录患者术毕24 h QoR-15评分、恶心呕吐发生率、肾功能以及肠道排气时间,测定术毕24、48 h患者血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-10的水平。结果与PPV组相比,PVI组术中总输液量、晶体输注量、尿量,术毕24 h和48 h血清IL-6水平更低,差异有统计学意义(P<0.05);两组低血压时间加权平均值、胶体输注量、术毕24 h肾功能、恶心呕吐发生率、肠道排气时间差异均无统计学差异(P>0.05)。结论在腹腔镜胃肠道肿瘤手术中,基于PVI的GDFT并不劣于PPV作为目标的GDFT,该方法无创、简便,值得在临床推广应用。

中药膏摩联合脉冲超短波治疗慢性踝关节扭伤的临床研究

目的:研究中药膏摩联合脉冲超短波治疗慢性踝关节扭伤的临床效果。方法:选取2020年1月—2022年8月北京市昌平区中西医结合医院门诊慢性踝关节扭伤患者80例,随机分为治疗组和对照组,每组40例。治疗组采用中药膏摩联合脉冲超短波治疗,对照组采用双氯芬酸二乙胺乳剂外用配合脉冲超短波治疗。在治疗前及治疗后第3、7、14、28、42天进行视觉模拟评分量表(VAS)评分、Kofoed踝关节功能评分,并测量患踝软组织周径(四点定位法),对两组临床疗效进行比较。结果:治疗第3、7、14、28、42天,治疗组患者踝关节VAS评分降低值均大于对照组,Kofoed踝关节功能评分升高值均大于对照组,踝关节周径减小值均大于对照组,差异有统计学意义(P<0.05);治疗14d后,治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。结论:中药膏摩联合脉冲超短波治疗慢性踝关节扭伤,具备较好的疗效,能够有效减轻患者关节疼痛、缓解关节肿胀、改善关节功能。

光动力疗法辅助治疗海分枝杆菌感染一例

海分枝杆菌感染的典型特征为皮肤感染性肉芽肿。抗生素是治疗海分枝杆菌皮肤感染的首选药物。本文报道了一例海分枝杆菌感染的中年女性,由于抗生素不耐受,给予光动力治疗和点阵激光辅助加速治疗后成功治愈。

脉冲CO_(2)激光结合牙周基础治疗对青春期龈炎前瞻性半口自身对照研究

目的基于半口自身对照研究观察脉冲CO_(2)激光结合牙周基础治疗对青春期龈炎的疗效。方法选择200例符合标准的青春期龈炎患者,采用左右半口自身对照研究,一侧行牙周基础治疗,为对照组;另一侧行脉冲CO_(2)激光结合牙周基础治疗,为治疗组。对比分析2组患者牙龈红肿、出血好转时间,治疗后7 d和6周时探诊深度(PD)>3 mm的位点数、探诊出血(BOP)阳性位点数、BOP百分率、牙龈指数(GI)、出血指数(BI)、菌斑指数(PLI)的变化以及龈沟液白细胞介素1β(IL-1β)、C-反应蛋白(CRP)、前列腺素E_(2)(PGE_(2))、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平的改变。结果治疗组牙龈红肿、出血好转时间均早于对照组(均P<0.05)。治疗后7 d和6周时,2组PD>3 mm的位点数、BOP阳性位点数和BOP百分率均降低(P<0.05),且治疗组较对照组更低(P<0.05)。治疗后7 d和6周时,2组PLI、GI、BI均降低(均P<0.05),且治疗组PLI、GI、BI均低于对照组(P<0.05)。治疗后6周时2组龈沟液IL-1β、CRP、PGE_(2)、TNF-α、IL-6水平均下降(均P<0.05),且治疗组低于对照组(均P<0.05)。结论相对于单纯牙周基础治疗,脉冲CO_(2)激光结合牙周基础治疗对青春期龈炎的临床疗效更佳,且能较快改善患者临床症状,降低局部炎性反应。