BACKGROUND Mesenchymal stromal cell(MSC)-based cellular therapy promotes type I collagen production,enhance mechanical strength of tissues,and enhance biology at the bone-tendon interface,which primarily explains thei...BACKGROUND Mesenchymal stromal cell(MSC)-based cellular therapy promotes type I collagen production,enhance mechanical strength of tissues,and enhance biology at the bone-tendon interface,which primarily explains their potential clinical utility in rotator cuff(RC)tears.AIM To analyze the efficacy and safety of cellular therapy utilizing MSCs in the management of RC tears from clinical studies available in the literature.METHODS We conducted independent and duplicate electronic database searches including PubMed,Embase,Reference Citation Anallysis,Web of Science,and Cochrane Library in August 2021 for studies analyzing the efficacy and safety of cellular therapy(CT)utilizing MSCs in the management of RC tears.Visual Analog Score(VAS)score for pain,American Shoulder and Elbow Surgeons(ASES)score,Disability of the Arm,Shoulder,and Hand score,Constant score,radiological assessment of healing,and complications such as retear rate and adverse events were the outcomes analyzed.Analysis was performed in R-platform using OpenMeta[Analyst]software.RESULTS Six studies involving 238 patients were included for analysis.We noted a significant reduction in VAS score for pain at 3 mo(weighed mean difference[WMD]=-2.234,P<0.001)and 6 mo(WMD=-3.078,P<0.001)with the use of CT,which was not maintained at long-term follow-up(WMD=-0.749,P=0.544).Concerning functional outcomes,utilization of CT produced a significant shortterm improvement in the ASES score(WMD=17.090,P<0.001)and significant benefit in functional scores such as Constant score(WMD=0.833,P=0.760)at long-term follow-up.Moreover,we also observed significantly improved radiological tendon healing during the longterm follow-up(odds ratio[OR]=3.252,P=0.059).We also noted a significant reduction in the retear rate upon utilization of CT in RC tears both at short-(OR=0.079,P=0.032)and long-term(OR=0.434,P=0.027)follow-ups.We did not observe any significant increase in the adverse events directly related to cellular therapy,as compared with the control group(OR=0.876,P=0.869).CONCLUSION Based on our comprehensive and critical review,we could observe that the utilization of CT in RC tear significantly reduced pain severity at 3 and 6 mo,improved short-term functional outcome,enhanced radiological tendon healing,and mitigated retear rates at both short-and long-term follow-ups.The literature also confirmed the relative safety of using MSC therapy in patients presenting with RC tears.展开更多
OBJECTIVE: To study the clinical comparison and analysis of decoction of Traditional Chinese Medicine(TCM) combined with ear acupoint application and simple artificial tears in the treatment of dry eye syndrome. METHO...OBJECTIVE: To study the clinical comparison and analysis of decoction of Traditional Chinese Medicine(TCM) combined with ear acupoint application and simple artificial tears in the treatment of dry eye syndrome. METHODS:A total of 62 patients(124 eyes) with dry eye syndrome treated in the Department of Ophthalmology of The 4th People's Hospital of Shenyang from July 2017 to March 2018 were selected and equally divided into 2 groups according to the admission order. The observation group received the combination therapy of TCM decoction and ear acupoint application, while the control group was given the simple artificial tears. The symptom score after 2 weeks, 4 weeks, and 8 weeks as well as the indicators including break-up time(BUT), Schirmer I test(SIT) and fluorescein(FL) were recorded and compared between groups. RESULTS: The symptom scores had no difference before treatment(P > 0.05), and were better in the observation group than those in the control group after treatment(P < 0.05). At 2 weeks, 4 weeks, and 8 weeks after the treatment, the amelioration level of BUT, SIT, and FL indicators in the observation group was better than that of the control group(P < 0.05). CONCLUSION: Compared with the artificial tears treatment method, the TCM decoction combined with ear acupoint application can significantly ameliorate the tear film stability, tear secretion, and reduce ocular surface damage for dry eye patients.展开更多
【目的】观察针刺治疗肝经郁热型干眼症的疗效及其对焦虑情绪的影响。【方法】将78例肝经郁热型干眼症患者随机分为观察组和对照组,每组各39例。对照组给予聚乙烯醇滴眼液滴眼治疗,观察组在对照组的基础上加用针刺治疗,疗程为1个月。观...【目的】观察针刺治疗肝经郁热型干眼症的疗效及其对焦虑情绪的影响。【方法】将78例肝经郁热型干眼症患者随机分为观察组和对照组,每组各39例。对照组给予聚乙烯醇滴眼液滴眼治疗,观察组在对照组的基础上加用针刺治疗,疗程为1个月。观察2组患者治疗前后主观症状评分、泪膜破裂时间(break-up time,BUT)、泪液分泌试验(Schirmer I test,SIT)、角膜荧光染色结果(fluorescein,FL)评分以及焦虑自评量表(SAS)评分的变化情况,并评价2组患者的临床疗效和焦虑改善疗效。【结果】(1)治疗1个月后,观察组的总有效率为89.74%(35/39),对照组为71.79%(28/39),组间比较,观察组的总有效率(χ^(2)检验)和总体疗效(秩和检验)均优于对照组(P<0.05)。(2)治疗后,2组患者的眼睛干燥感、异物感、疲劳感、烧灼感、不适感、视力波动等各项主观症状评分及总积分均较治疗前明显降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.05或P<0.01)。(3)治疗后,2组患者的BUT、SIT、FL评分均较治疗前明显改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的SAS评分均较治疗前明显降低(P<0.05),且观察组的降低作用明显优于对照组(P<0.01)。(5)治疗后,观察组的焦虑恢复正常率为89.29%(25/28),对照组为48.15%(13/27),组间比较(χ^(2)检验),观察组的焦虑改善疗效明显优于对照组(P<0.05)。【结论】在人工泪液治疗基础上加用针刺治疗肝经郁热型干眼症患者疗效确切,可有效改善患者临床症状和焦虑情绪,其疗效优于单纯人工泪液治疗。展开更多
BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in reliev...BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in relieving the distressing symptoms of DES.This study aimed to evaluate the safety and effectiveness of ASEDs compared to traditional treatments,which often prove inadequate or result in unwanted side effects,particularly in individuals with moderate-to-severe DES.AIM To evaluate whether ASEDs are safer and more effective than conventional artificial tears in the treatment of moderate-to-severe DES.METHODS This multi-centered randomized controlled trial included 240 patients with moderate-to-severe DES from three ophthalmology clinics in China.They were randomly assigned to receive either ASEDs or artificial tears for 12 wk.The primary outcome was the change in the ocular surface disease index(OSDI)score,with secondary outcomes including tear break-up time(TBUT),Schirmer I test,corneal fluorescein staining(CFS),and conjunctival impression cytology(CIC).Statistics analysis was performed using an analysis of covariance with adjustments made for baseline values.RESULTS Our findings revealed that both ASEDs and artificial tears significantly improved the OSDI score,TBUT,Schirmer I test,CFS,and CIC from baseline to week 12.The ASEDs group showed significantly greater improvement in all these measures than the artificial tears group(all P values<0.05).The average difference in the OSDI score between the two cohorts was-10.3(95%confidence interval:-13.6 to-7.0),indicating a substantial improvement in the ASEDs group.The occurrence of adverse events was comparable between cohorts,with no reports of severe adverse events.CONCLUSION ASEDs are more effective and safer than artificial tears for mitigating symptoms of moderate-to-severe DES.ASEDs could be an alternative/supplementary therapy for patients with DES less responsive to traditional treatments.展开更多
目的退行性半月板撕裂的最佳治疗方案仍有争议,通过荟萃分析探讨关节镜下半月板成形术联合运动疗法对比单纯运动疗法治疗退行性半月板撕裂的临床疗效。方法依据PICOS原则,检索公开发表于PubMed、EMBASE、Web of science、中国知网、中...目的退行性半月板撕裂的最佳治疗方案仍有争议,通过荟萃分析探讨关节镜下半月板成形术联合运动疗法对比单纯运动疗法治疗退行性半月板撕裂的临床疗效。方法依据PICOS原则,检索公开发表于PubMed、EMBASE、Web of science、中国知网、中国万方数据数据库关于对比半月板成形术联合运动疗法和单纯运动疗法治疗退行性半月板撕裂的前瞻性随机对照试验(RCT)文献,检索时间由建库至2022年9月30日。根据Cochrane手册进行系统评价的文献筛选和数据提取,并进行文献质量评价。根据是否有异质性选择固定效应或者随机效应模型行meta分析,结果用森林图显示。结果最终纳入了12项RCT,包含1306名患者。总体偏倚风险都被评定为低风险,漏斗图和Egger检验显示无明显偏移风险。对于疼痛评分,两组在2月、6月、12月和24月的差异均无统计学意义(P>0.05)。而对于功能评分,结果显示在2月时,关节镜下半月板成形术联合运动疗法比单纯运动疗法更高(MD=3.31;95%CI:1.60~5.03;P<0.01)。而在6月、12月、24月和5年时,两组的功能评分也无显著差异。结论在早期的功能评分方面,关节镜下半月板成形术联合运动疗法效果更优。然而在中长期随访中疼痛和功能评分均没有差异。因此临床工作中应重视运动疗法在治疗退行性半月板撕裂方面的潜能。展开更多
目的观察针刺配合中药及人工泪液治疗肝肾阴亏型泪液缺乏性干眼症的临床疗效。方法将80例肝肾阴亏型泪液缺乏性干眼症患者随机分为A组30例、B组25例和C组25例。A组采用针刺配合中药及人工泪液治疗,B组采用中药配合人工泪液治疗,C组采用...目的观察针刺配合中药及人工泪液治疗肝肾阴亏型泪液缺乏性干眼症的临床疗效。方法将80例肝肾阴亏型泪液缺乏性干眼症患者随机分为A组30例、B组25例和C组25例。A组采用针刺配合中药及人工泪液治疗,B组采用中药配合人工泪液治疗,C组采用单纯人工泪液治疗。观察各组治疗前后视力、泪液分泌试验(Schirmer I test, SIT)、泪膜破裂时间(break-up time, BUT)、角膜荧光染色(fluorescein staining, FL)、眼部症状评分及中医证候评分的变化情况,并比较各组临床疗效。结果 A组治疗后双眼视力与同组治疗前比较,差异均具有统计学意义(P<0.01);B组治疗后左眼视力与同组治疗前比较,差异具有统计学意义(P<0.05)。各组治疗后双眼SIT、BUT、FL评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。A组治疗后双眼视力评分、SIT与B组和C组比较,差异均具有统计学意义(P<0.01,P<0.05)。A组和B组治疗后双眼BUT、FL评分与C组比较,差异均具有统计学意义(P<0.05,P<0.01)。B组治疗后右眼FL评分与C组比较,差异具有统计学意义(P<0.05)。A组和B组治疗后各项眼部症状(干涩感、异物感、疲劳感)评分与同组治疗前比较,差异均有统计学意义(P<0.01);C组治疗后干涩感、疲劳感评分与同组治疗前比较,差异均有统计学意义(P<0.01,P<0.05)。A组治疗后各项眼部症状评分与C组比较,差异均具有统计学意义(P<0.01);B组治疗后干涩感评分与C组比较,差异具有统计学意义(P<0.05)。A组总有效率为93.3%,B组为80.0%,C组为40.0%;A组中医证候总有效率为90.0%,B组为80.0%,C组为8.0%。A组和B组总有效率及中医证候总有效率与C组比较,差异均具有统计学意义(P<0.01)。结论针刺配合中药及人工泪液是一种治疗肝肾阴亏型泪液缺乏性干眼症的有效方法,可缓解患者症状,提高视力。展开更多
文摘BACKGROUND Mesenchymal stromal cell(MSC)-based cellular therapy promotes type I collagen production,enhance mechanical strength of tissues,and enhance biology at the bone-tendon interface,which primarily explains their potential clinical utility in rotator cuff(RC)tears.AIM To analyze the efficacy and safety of cellular therapy utilizing MSCs in the management of RC tears from clinical studies available in the literature.METHODS We conducted independent and duplicate electronic database searches including PubMed,Embase,Reference Citation Anallysis,Web of Science,and Cochrane Library in August 2021 for studies analyzing the efficacy and safety of cellular therapy(CT)utilizing MSCs in the management of RC tears.Visual Analog Score(VAS)score for pain,American Shoulder and Elbow Surgeons(ASES)score,Disability of the Arm,Shoulder,and Hand score,Constant score,radiological assessment of healing,and complications such as retear rate and adverse events were the outcomes analyzed.Analysis was performed in R-platform using OpenMeta[Analyst]software.RESULTS Six studies involving 238 patients were included for analysis.We noted a significant reduction in VAS score for pain at 3 mo(weighed mean difference[WMD]=-2.234,P<0.001)and 6 mo(WMD=-3.078,P<0.001)with the use of CT,which was not maintained at long-term follow-up(WMD=-0.749,P=0.544).Concerning functional outcomes,utilization of CT produced a significant shortterm improvement in the ASES score(WMD=17.090,P<0.001)and significant benefit in functional scores such as Constant score(WMD=0.833,P=0.760)at long-term follow-up.Moreover,we also observed significantly improved radiological tendon healing during the longterm follow-up(odds ratio[OR]=3.252,P=0.059).We also noted a significant reduction in the retear rate upon utilization of CT in RC tears both at short-(OR=0.079,P=0.032)and long-term(OR=0.434,P=0.027)follow-ups.We did not observe any significant increase in the adverse events directly related to cellular therapy,as compared with the control group(OR=0.876,P=0.869).CONCLUSION Based on our comprehensive and critical review,we could observe that the utilization of CT in RC tear significantly reduced pain severity at 3 and 6 mo,improved short-term functional outcome,enhanced radiological tendon healing,and mitigated retear rates at both short-and long-term follow-ups.The literature also confirmed the relative safety of using MSC therapy in patients presenting with RC tears.
文摘OBJECTIVE: To study the clinical comparison and analysis of decoction of Traditional Chinese Medicine(TCM) combined with ear acupoint application and simple artificial tears in the treatment of dry eye syndrome. METHODS:A total of 62 patients(124 eyes) with dry eye syndrome treated in the Department of Ophthalmology of The 4th People's Hospital of Shenyang from July 2017 to March 2018 were selected and equally divided into 2 groups according to the admission order. The observation group received the combination therapy of TCM decoction and ear acupoint application, while the control group was given the simple artificial tears. The symptom score after 2 weeks, 4 weeks, and 8 weeks as well as the indicators including break-up time(BUT), Schirmer I test(SIT) and fluorescein(FL) were recorded and compared between groups. RESULTS: The symptom scores had no difference before treatment(P > 0.05), and were better in the observation group than those in the control group after treatment(P < 0.05). At 2 weeks, 4 weeks, and 8 weeks after the treatment, the amelioration level of BUT, SIT, and FL indicators in the observation group was better than that of the control group(P < 0.05). CONCLUSION: Compared with the artificial tears treatment method, the TCM decoction combined with ear acupoint application can significantly ameliorate the tear film stability, tear secretion, and reduce ocular surface damage for dry eye patients.
文摘【目的】观察针刺治疗肝经郁热型干眼症的疗效及其对焦虑情绪的影响。【方法】将78例肝经郁热型干眼症患者随机分为观察组和对照组,每组各39例。对照组给予聚乙烯醇滴眼液滴眼治疗,观察组在对照组的基础上加用针刺治疗,疗程为1个月。观察2组患者治疗前后主观症状评分、泪膜破裂时间(break-up time,BUT)、泪液分泌试验(Schirmer I test,SIT)、角膜荧光染色结果(fluorescein,FL)评分以及焦虑自评量表(SAS)评分的变化情况,并评价2组患者的临床疗效和焦虑改善疗效。【结果】(1)治疗1个月后,观察组的总有效率为89.74%(35/39),对照组为71.79%(28/39),组间比较,观察组的总有效率(χ^(2)检验)和总体疗效(秩和检验)均优于对照组(P<0.05)。(2)治疗后,2组患者的眼睛干燥感、异物感、疲劳感、烧灼感、不适感、视力波动等各项主观症状评分及总积分均较治疗前明显降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.05或P<0.01)。(3)治疗后,2组患者的BUT、SIT、FL评分均较治疗前明显改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的SAS评分均较治疗前明显降低(P<0.05),且观察组的降低作用明显优于对照组(P<0.01)。(5)治疗后,观察组的焦虑恢复正常率为89.29%(25/28),对照组为48.15%(13/27),组间比较(χ^(2)检验),观察组的焦虑改善疗效明显优于对照组(P<0.05)。【结论】在人工泪液治疗基础上加用针刺治疗肝经郁热型干眼症患者疗效确切,可有效改善患者临床症状和焦虑情绪,其疗效优于单纯人工泪液治疗。
文摘BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in relieving the distressing symptoms of DES.This study aimed to evaluate the safety and effectiveness of ASEDs compared to traditional treatments,which often prove inadequate or result in unwanted side effects,particularly in individuals with moderate-to-severe DES.AIM To evaluate whether ASEDs are safer and more effective than conventional artificial tears in the treatment of moderate-to-severe DES.METHODS This multi-centered randomized controlled trial included 240 patients with moderate-to-severe DES from three ophthalmology clinics in China.They were randomly assigned to receive either ASEDs or artificial tears for 12 wk.The primary outcome was the change in the ocular surface disease index(OSDI)score,with secondary outcomes including tear break-up time(TBUT),Schirmer I test,corneal fluorescein staining(CFS),and conjunctival impression cytology(CIC).Statistics analysis was performed using an analysis of covariance with adjustments made for baseline values.RESULTS Our findings revealed that both ASEDs and artificial tears significantly improved the OSDI score,TBUT,Schirmer I test,CFS,and CIC from baseline to week 12.The ASEDs group showed significantly greater improvement in all these measures than the artificial tears group(all P values<0.05).The average difference in the OSDI score between the two cohorts was-10.3(95%confidence interval:-13.6 to-7.0),indicating a substantial improvement in the ASEDs group.The occurrence of adverse events was comparable between cohorts,with no reports of severe adverse events.CONCLUSION ASEDs are more effective and safer than artificial tears for mitigating symptoms of moderate-to-severe DES.ASEDs could be an alternative/supplementary therapy for patients with DES less responsive to traditional treatments.
文摘目的退行性半月板撕裂的最佳治疗方案仍有争议,通过荟萃分析探讨关节镜下半月板成形术联合运动疗法对比单纯运动疗法治疗退行性半月板撕裂的临床疗效。方法依据PICOS原则,检索公开发表于PubMed、EMBASE、Web of science、中国知网、中国万方数据数据库关于对比半月板成形术联合运动疗法和单纯运动疗法治疗退行性半月板撕裂的前瞻性随机对照试验(RCT)文献,检索时间由建库至2022年9月30日。根据Cochrane手册进行系统评价的文献筛选和数据提取,并进行文献质量评价。根据是否有异质性选择固定效应或者随机效应模型行meta分析,结果用森林图显示。结果最终纳入了12项RCT,包含1306名患者。总体偏倚风险都被评定为低风险,漏斗图和Egger检验显示无明显偏移风险。对于疼痛评分,两组在2月、6月、12月和24月的差异均无统计学意义(P>0.05)。而对于功能评分,结果显示在2月时,关节镜下半月板成形术联合运动疗法比单纯运动疗法更高(MD=3.31;95%CI:1.60~5.03;P<0.01)。而在6月、12月、24月和5年时,两组的功能评分也无显著差异。结论在早期的功能评分方面,关节镜下半月板成形术联合运动疗法效果更优。然而在中长期随访中疼痛和功能评分均没有差异。因此临床工作中应重视运动疗法在治疗退行性半月板撕裂方面的潜能。
文摘目的观察针刺配合中药及人工泪液治疗肝肾阴亏型泪液缺乏性干眼症的临床疗效。方法将80例肝肾阴亏型泪液缺乏性干眼症患者随机分为A组30例、B组25例和C组25例。A组采用针刺配合中药及人工泪液治疗,B组采用中药配合人工泪液治疗,C组采用单纯人工泪液治疗。观察各组治疗前后视力、泪液分泌试验(Schirmer I test, SIT)、泪膜破裂时间(break-up time, BUT)、角膜荧光染色(fluorescein staining, FL)、眼部症状评分及中医证候评分的变化情况,并比较各组临床疗效。结果 A组治疗后双眼视力与同组治疗前比较,差异均具有统计学意义(P<0.01);B组治疗后左眼视力与同组治疗前比较,差异具有统计学意义(P<0.05)。各组治疗后双眼SIT、BUT、FL评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。A组治疗后双眼视力评分、SIT与B组和C组比较,差异均具有统计学意义(P<0.01,P<0.05)。A组和B组治疗后双眼BUT、FL评分与C组比较,差异均具有统计学意义(P<0.05,P<0.01)。B组治疗后右眼FL评分与C组比较,差异具有统计学意义(P<0.05)。A组和B组治疗后各项眼部症状(干涩感、异物感、疲劳感)评分与同组治疗前比较,差异均有统计学意义(P<0.01);C组治疗后干涩感、疲劳感评分与同组治疗前比较,差异均有统计学意义(P<0.01,P<0.05)。A组治疗后各项眼部症状评分与C组比较,差异均具有统计学意义(P<0.01);B组治疗后干涩感评分与C组比较,差异具有统计学意义(P<0.05)。A组总有效率为93.3%,B组为80.0%,C组为40.0%;A组中医证候总有效率为90.0%,B组为80.0%,C组为8.0%。A组和B组总有效率及中医证候总有效率与C组比较,差异均具有统计学意义(P<0.01)。结论针刺配合中药及人工泪液是一种治疗肝肾阴亏型泪液缺乏性干眼症的有效方法,可缓解患者症状,提高视力。
