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To explore the effectiveness and safety of a Chinese medicinal decoction Wuwei Xiaodu Drink (WWXDD) in inhibiting chronic osteomyelitis via regulatory T cells signaling. The effective constitutes of WWXDD and osteomyelitis related genes were screened. Target proteins were cross-validated using the Venny database. GO function and KEGG pathway analysis were performed for target proteins, while pharmacological network was constructed. The bone properties were analyzed by HE staining and the concentrations of immune factors were measured by ELISA. The expression of CTLA-4 and Foxp3 mRNA and STAT5, p-STAT5, CTLA-4 and Foxp3 protein were detected using Real-time PCR and Western blot, respectively. FACS was used to analyze the percentages of cells. A total of 117 genes overlapped between 785 target genes of the active compounds of WWXDD and 912 osteomyelitis related genes. Inflammation-related genes, including IL-6, TNFα, IL-1β and IL-2 showed high connection degree in the drug-compound-disease-target network. GO function and KEGG pathway analysis revealed that 117 intersection genes mainly enriched in virus infection related pathways, immune related pathways and chemokine signaling pathway. Furthermore, the development of chronic osteomyelitis was suppressed in model rats after treatment with WWXDD. Meanwhile, the concentrations of IL-2 and CD4+CD25+Foxp3 Treg percentages together with the levels of p-STAT5, CTLA-4 and Foxp3 were also down-regulated. Furthermore, IL-2 and WWXDD drug-containing serum exhibited opposite effects on regulating IL-2, IL-10, TGF-β1, Foxp3, CTLA4 and STAT5. In addition, a STAT5 phosphorylation inhibitor suppressed the expression of Foxp3 and CTLA-4. WWXDD can treat chronic osteomyelitis through suppressing the main regulating factors of Tregs and interfere its immunodepression. Our results bring a new solution for chronic osteomyelitis.
Subject(s)
Animals , Rats , Forkhead Transcription Factors/metabolism , Interleukin-2/metabolism , Osteomyelitis/metabolism , STAT5 Transcription Factor/metabolism , Signal Transduction , T-Lymphocytes, RegulatoryABSTRACT
OBJECTIVE@#To summarize and discuss the clinical efficacy and application value of intravenous drip of linezolid combined with local targeted sustained-release of vancomycin in the treatment of traumatic osteomyelitis of extremities infected with MRSA.@*METHODS@#Thirty patients with traumatic osteomyelitis of extremities infected by MRSA from March 2015 to March 2017 were analyzed retrospectively, including 21 males and 9 females; aged 25 to 64 years old, with an average age of(47.94± 6.23) years old;the course of disease ranged from 9 to 23 months, with an average of (15.68±6.23) months. The lesions were located in tibia in 18 cases and calcaneus in 12 cases. The causes of injury were fall injury in 12 cases, trafficaccident injury in 9 cases and fall injury in 9 cases. There were 22 patients with closed fractures and 8 patients with open fractures. There were 13 cases of internal fixation. Twenty-two patients had sinustract, 8 patients had soft tissue defect with bone and internal fixation exposure, soft tissue defect area ranged from 2.0 cm × 3.0 cm to 8.2 cm × 12.3 cm;10 patients had bone defect, defect area ranged from 0.5 to 3.4 cm;bacterial culture of sinus tract or wound secretion in all patients was MRSA. On the basis of thorough debridement, calcium sulfate artificial bone loaded with vancomycin was implanted in the lesion, and linezolid and glucose injection was given intravenously during the perioperative period. The patients were followed up regularly according to the time of antibiotic use, blood routine, erythrocyte sedimentation rate, high-sensitivity C-reactive protein, liver and kidney function and other related laboratory indexes, X-ray, CT and other imaging examinations, bone healing, flap survival, joint function and McKee's osteomyelitis cure criteria.@*RESULTS@#All the patients were followed up, and the duration ranged from 3 to 6 years, with a mean of (4.23±0.76) years. No recurrence of osteomyelitis occurred. Fracture healing, infection control, wound healing and functional recovery were achieved.@*CONCLUSION@#Intravenous drip of linezolid combined with local targeted sustained-release of vancomycin for the treatment of MRSA infected traumatic osteomyelitis in limbs have significant effects and low recurrence rates.
Subject(s)
Adult , Female , Humans , Infant , Male , Middle Aged , Extremities , Methicillin-Resistant Staphylococcus aureus , Osteomyelitis , Retrospective Studies , Surgical Flaps , Treatment OutcomeABSTRACT
Cytotoxic anti-neoplastic drugs are a kind of chemotherapeutic drugs that directly kill or inhibit the growth and proliferation of tumor cells, and it is one of the main drugs for the treatment of malignant tumors. These drugs may have toxic side effects on normal cells of human body (especially those with strong division and proliferation) when they are used to kill tumor cells. And patients may usually have adverse reactions even at a normal dose when using this kind of drugs. Due to the strong toxic side effects of cytotoxic chemotherapeutic drugs, their clinical application is limited. In recent years it has been found that aminopeptidase N inhibitor Ubenimex has a significant synergistic effect with anti-neoplastic chemotherapeutic drugs, which has the advantages of enhancing the therapeutic effect of drugs and reducing the toxic side effects of chemotherapeutic drugs. This review enumerates that the combination of Ubenimex and a variety of cytotoxic drugs can enhance the anti-tumor effect of cytotoxic drugs and reduce the occurrence of adverse reactions. In addition, the mechanism of combined use of Ubenimex in reversing drug resistance is also introduced. At the same time, is is further confirmed the clinical value of Ubenimex as an effective adjuvant in the treatment of malignant tumors, so as to provide a basis for clinical application.
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Hepatitis B has become one of the major diseases which seriously affect people's health and social development. Hepatitis B, with high incidence and long disease course, cannot be cured by approved drugs such as the nucleoside analogues. Therefore, the discovery of safe and efficient novel HBV inhibitors is of great significance. From the point of view of medicinal chemistry, we summarized and discussed current endeavours towards the discovery and development of anti-HBV agents of RNase H and other novel target inhibitors with various scaffolds or distinct mechanisms of action, besides the existing capsid protein inhibitors.
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Hepatitis B virus (HBV) capsid protein plays an important role in the life cycle, thus becoming an ideal target for drug design. Capsid protein inhibitors can exert a synergistic antiviral effect with nucleoside drugs by inhibiting the replication of HBV. This paper reviews the research progress of capsid protein inhibitors with different structural types from the perspective of medicinal chemistry.
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OBJECTIVE@#To explore the appropriate procedures for preparing extracellular microvesicles (MV) derived from human mesenchymal stem cells (MSC).@*METHODS@#Human MSCs from umbilical cords were cultured in a serum-free medium and maintained in a basal medium for 72 hours after the cell confluence reached to 80%. The supernatants of cultured cells were collected and MVs were enriched. MVs were identified by flow cytometry and electron microscopy. The total protein amount in MVs was used as a parameter for the content of MVs. The supernatants were adjusted to different pH values, and the output of MVs was detected. The supernatants were also collected for enriching the MV and detecting the protein content of MV after the cells were maintained in the basic medium for different time.@*RESULTS@#Flow cytometric analysis showed that the MVs expressed CD9, CD63 and CD81, morphologically presented round under an electron microscope and the diameter of MV was around 100 nm. After enrichment of MV, the protein content of MVs in the supernatants was 416.8±128.1, 255.4±77.9 and 142.8±46.4 μg per 10 MSC，respectively at pH of supernatant 3, 7 and 9 (P＜0.05). The protein content of the supernatants per 10 MSC was 173.6±44.5, 262.4±49.6 and 364.2±37.8 μg respectively after starvation culture for 48, 72 and 96 hrs (P＜0.05).@*CONCLUSION@#MVs can be readily collected after MSCs were starved for 96 hours, and the pH of the supernatants is adjusted at 3.0.
Subject(s)
Humans , Cell-Derived Microparticles , Cells, Cultured , Flow Cytometry , Mesenchymal Stem Cells , Umbilical CordABSTRACT
Objective To compare the approaches used for the assessment of disability adjust life years (DALYs) for advanced schistosomiasis japonica, so as to provide scientific evidence for accurate assessment of the burden of advanced schistosomiasis japonica. Methods The patients with advanced schistosomiasis japonica receiving treatment and assistance programs in Hunan Province in 2017 were enrolled, and the years lived with disability (YLD) for the patients with advanced schistosomiasis japonica was calculated using the common global burden of disease (GBD) estimation method, the modified GBD method with addition of common syndromes of advanced schistosomiasis japonica, and the quality of life assessment method. Results The YLDs of patients with advanced schistosomiasis japonica, the mean YLDs per capita, and the percentages of YLD were 673.94, 728.77 person-years and 1 761.99 person-years; 0.181, 0.196 person-years and 0.474 person-years; and 10.61, 11.48 person-years per 100 thousand persons and 27.75 person-years per 100 thousand persons with the common GBD method, modified GBD method and the quality of life method, respectively. The YLDs of the patients with advanced schistosomiasis japonica in Hunan Province estimated with the modified GBD method and the quality of life method were 8.14% and 2.61 times higher than that with the common GBD method. Of the major symptoms included in the calculation, the 5 symptoms with the greatest contribution to the burden of advanced schistosomiasis japonica included ascites, moderate anemia, severe anemia, diarrhea and hematochezia. Conclusion The quality of life method may more comprehensively assess the YLDs in patients with advanced schistosomiasis japonica than the common and modified GBD methods.
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Objective To compare the approaches used for the assessment of disability adjust life years (DALYs) for advanced schistosomiasis japonica, so as to provide scientific evidence for accurate assessment of the burden of advanced schistosomiasis japonica. Methods The patients with advanced schistosomiasis japonica receiving treatment and assistance programs in Hunan Province in 2017 were enrolled, and the years lived with disability (YLD) for the patients with advanced schistosomiasis japonica was calculated using the common global burden of disease (GBD) estimation method, the modified GBD method with addition of common syndromes of advanced schistosomiasis japonica, and the quality of life assessment method. Results The YLDs of patients with advanced schistosomiasis japonica, the mean YLDs per capita, and the percentages of YLD were 673.94, 728.77 person-years and 1 761.99 person-years; 0.181, 0.196 person-years and 0.474 person-years; and 10.61, 11.48 person-years per 100 thousand persons and 27.75 person-years per 100 thousand persons with the common GBD method, modified GBD method and the quality of life method, respectively. The YLDs of the patients with advanced schistosomiasis japonica in Hunan Province estimated with the modified GBD method and the quality of life method were 8.14% and 2.61 times higher than that with the common GBD method. Of the major symptoms included in the calculation, the 5 symptoms with the greatest contribution to the burden of advanced schistosomiasis japonica included ascites, moderate anemia, severe anemia, diarrhea and hematochezia. Conclusion The quality of life method may more comprehensively assess the YLDs in patients with advanced schistosomiasis japonica than the common and modified GBD methods.
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OBJECTIVE@#To evaluate the efficacy and safety of essential oil treatment for type III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).@*METHODS@#A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type III CP/CPPS patients were assigned to the essential oil group (35 cases) or almond placebo oil control group (35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index (NIH-CPSI) and expressed prostatic secretions (EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed.@*RESULTS@#Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations (P>0.05). In the essential oil group, pain between rectum and testicles (perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group (P<0.01). No serious adverse events occurred.@*CONCLUSION@#The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS. (Registration No. ChiCTR-IPR-14005448).
Subject(s)
Adult , Humans , Male , Chronic Pain , Drug Therapy , Oils, Volatile , Therapeutic Uses , Pelvic Pain , Drug Therapy , Pilot Projects , Prostatitis , Drug Therapy , Syndrome , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs).@*METHODS@#Two hundreds eligible adult patients suffering from STIs were recruited and received sinew acupuncture with flexible treatment schedules. The number of treatment sessions was pragmatically decided by each patient on the basis of their pain relief. The outcome measurement was the change of pain rating in the Visual Analogue Scale (VAS) during the first 5 sessions. The adverse effect was also observed.@*RESULTS@#Of the 200 patients recruited, 7 were excluded due to incomplete data. In total, 888 sinew acupuncture treatments were administered to patients at 14 injury sites (including head, neck, shoulder, arm, chest, elbow, wrist, hand, waist and hip, knee, thigh, calf, ankle, and foot) where pain was felt. Compared with the baseline, the VAS rating after the first and last treatments were both significantly reduced at all the injury sites (P<0.01). The VAS rating was also significantly reduced after each session of treatment in the first five sessions (P<0.01). No serious adverse effect was observed.@*CONCLUSION@#Sinew acupuncture had not only an immediate analgesic effect for STIs, but also an accumulated analgesic effect during the first 5 treatment sessions.
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Posterior long-segment spinal fusion may lead to proximal junctional kyphosis (PJK). The present study sought to identify the appropriate fusion levels required in order to prevent PJK using finite element analysis. A finite element model was constructed based on the whole-spine computed tomography findings of a healthy adult. Nine commonly used posterior spinal fusion methods were selected. Stress on the annulus fibrosis fibers, the posterior ligamentous complex, and the vertebrae after various spinal fusions in the upright position were compared. This study was divided into two groups: non-fusion and fusion. In the former, the stress between the T10 and the upper thoracic vertebrae was higher. Comparing thoracic and lumbar segments in the fusion group, the peak stress values of the upper instrumented vertebrae (UIV) were mainly observed in T2 and L2 whilst those of the UIV+1 were observed in T10 and L2. After normalization, the peak stress values of the UIV and UIV+1 were located in T2 and L2. Similarly, the peak stress values of the annulus fibrosus at the upper adjacent level were on T10 and L2 after normalization. However, the peak stress values of the interspinal/supraspinal complex forces were concentrated on T11, T12, and L1 after normalization whilst the peak stress value of the pedicle screw was on T2. Controversy remains over the fusion of T10, and this study simulated testing conditions with gravitational loading only. However, further assessment is needed prior to reaching definitive conclusions.
Subject(s)
Humans , Male , Middle Aged , Orthopedics/methods , Spinal Fusion/instrumentation , Kyphosis/surgery , Scoliosis/surgery , Spinal Fusion/methods , Biomechanical Phenomena , Imaging, Three-Dimensional , Lumbar Vertebrae/surgeryABSTRACT
Objective To understand the disease burden of patients with advanced schistosomiasis in Jiangsu Province. Methods Totally 450 patients with advanced schistosomiasis from southern, northern and central Jiangsu were chosen by the stratified sampling method, and surveyed by the self-designed economic burden questionnaire in 2015. The economic burden of the patients was analyzed by the descriptive analysis method, and its determinants were explored by the multiple linear regression analysis. Results A total of 450 subjects were surveyed and 434 valid questionnaires were recovered with the recovery rate of 96.44%. The per capita economic burden of advanced schistosomiasis patients was 10 217 Yuan in Jiangsu Province in 2015, including 7 221 Yuan in direct economic burden and 2 996 Yuan in indirect economic burden. The average lost labor force time was 140 days for the patients, and was 23 days for the family. The multiple linear regression analysis showed that the marital status, hospitalization health service utilization, and self-reported health score impacted on the disease economic burden. Conclusion The disease burden of patients with advanced schistosomiasis in Jiangsu Province is heavy.
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Objective To understand the disease burden of patients with advanced schistosomiasis in Jiangsu Province. Methods Totally 450 patients with advanced schistosomiasis from southern, northern and central Jiangsu were chosen by the stratified sampling method, and surveyed by the self-designed economic burden questionnaire in 2015. The economic burden of the patients was analyzed by the descriptive analysis method, and its determinants were explored by the multiple linear regression analysis. Results A total of 450 subjects were surveyed and 434 valid questionnaires were recovered with the recovery rate of 96.44%. The per capita economic burden of advanced schistosomiasis patients was 10 217 Yuan in Jiangsu Province in 2015, including 7 221 Yuan in direct economic burden and 2 996 Yuan in indirect economic burden. The average lost labor force time was 140 days for the patients, and was 23 days for the family. The multiple linear regression analysis showed that the marital status, hospitalization health service utilization, and self-reported health score impacted on the disease economic burden. Conclusion The disease burden of patients with advanced schistosomiasis in Jiangsu Province is heavy.
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18F-FET PET imaging had its fundamental principle introduced, and then had its application to brain glioma diagnosis described from the aspects of patient survival period estimation, facilitating radiotherapy planning, post-radiotherapy effect monitoring and pseudoprogression neuroimaging evaluation. The advantages and disadvantages of 18F-FET PET were analyzed when used to diagnose brain glioma, and it's pointed out that 18F-FET PET combined with structural imaging technologies such as MRI spectral analysis, perfusion and diffusion-weighted imaging contributed to enhancing the accuracy of brain glioma diagnosis, positioning, differentiating, grading, prognosis prediction and treatment.
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BACKGROUND: Senile degenerative lumbar spinal stenosis typically manifests clinically as lower back and leg pain caused by compression of the nerve root. Conventional total laminectomy for degenerative lumbar spinal stenosis can quickly alleviate a patient's symptoms, but produces an unsatisfactory therapeutic effect because of spinal instability caused by degenerative spondylolisthesis, and also has many adverse reactions. OBJECTIVE: The purpose of this study is to investigate whether total laminectomy combined with lumbar pedicle screw fixation for treatment of senile degenerative lumbar spinal stenosis can effectively reduce lower back and leg pain caused by compression of the nerve root, increase lumbar spine stability, and reduce adverse reactions. METHODS: A prospective, single-center, self-control, interventional trial. One hundred and sixty older adult patients with degenerative lumbar spinal stenosis who will receive treatment at the Department of Orthopedics, Qinghai Provincial People's Hospital, China will be included in this study. All patients will undergo total laminectomy combined with lumbar pedicle screw fixation, with follow-up at 3, 6, 9, and 12 months post-surgery. RESULTS AND CONCLUSION: The primary outcome measure of this study is recovery rate in Japanese Orthopedic Society (JOA) score at 12 months post-surgery, which is used to evaluate improvements in patients lower back and leg pain. Secondary outcome measures of this study include changes in JOA score, spinal canal diameter, lumbar spine morphology displayed on computed tomography images, and incidence of adverse events post-surgery. Results of a preliminary study involving 71 older adult patients with degenerative lumbar spinal stenosis who received the same treatment showed that at 3 months post-surgery, JOA score and spinal canal diameter were significantly increased compared with before surgery (P < 0.05). Findings from this study may provide clinical evidence supporting that total laminectomy combined with lumbar pedicle screw fixation is a safe and reliable method for treatment of senile degenerative lumbar spinal stenosis because it rapidly alleviates lower back and leg pain and provides spine stability. This study was approved by Medical Ethics Committee of Qinghai Provincial People's Hospital of China(approval No.QHY201602G).This study will be performed in strict accordance with the Declaration of Helsinki formulated by the World Medical Association.Participants provided signed informed consent prior to participation in the study.This study was designed in December 2017. Patient recruitment and data collection will begin in August 2018. Data analysis will be performed in October 2019. The study will be completed in December 2019. Results will be disseminated through presentations at scientific meetings and/or by publication in a peer-reviewed journal. The version of this study protocol is (1.0). This trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800014726).
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Purpose To investigate the consistency and clinicopathologic correlation of BRAFV600E protein expression and gene mutation in papillary thyroid carcinoma. Methods BRAFV600E protein expression and genn mutation was detected respectively by immunohistochemistry of SP and real time-PCR, then the consistency between the both methods was analyzed by Kappa-test, the correlation between BRAFV600E and clinicopatho-logic parameters was analyzed by Chi-square test in papillary thyroid carcinoma. Results The gene mutation and protein expression rates of BRAFV600E were 89.3％ and 88.3％, respec-tively, the differences were not significant, the concordance rate of the both methods was 97.0％, Kappa value was 0.847, the consistence was higher, meanwhile the mutation rates between age ＜45 and ≥45 were respectively 96.8％ and 85.9％, there were significant differences, the positive rates of the both detec-tion methods were higher in thyroid capsule invaded group than non-invaded group, the differences were significant. Conclusion The both methods have higher consistency, the immunohisto-chemistry can be used as an initial screening tool for detecting gene mutation, the gene mutation of BRAFV600E is significantly associated with age and capsule invasion, the relationship is not found between BRAFV600E mutation and the other clinicopatholog-ic parameters.
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The acquired immunodeficiency syndrome (AIDS) is a serious infectious disease infected by human immunodeficiency virus type 1 (HIV-1). HIV-1 nucleocapsid protein 7 (HIV-1 NCp7) plays an important role in the progress of virus reverse transcription and integration. Thus, the central role and conservative nature of the NCp7 protein make it an attractive target for development of novel anti-HIV agents. This review summarizes the research progress of HIV-1 NCp7 inhibitors in the past decade.
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<p><b>OBJECTIVE</b>To evaluate the efficacy of Chinese medicine (CM) adjunct to conventional medications for idiopathic Parkinson's disease (PD).</p><p><b>METHODS</b>Electronic English and Chinese databases including PubMed, Cochrane Library, Web of Science, Chinese Medical Current Contents, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Med Database, and Traditional Chinese Medical Database System were used for key words searching in a highly sensitive search strategy. The extracted data was analyzed by the Review Manager 5.0.</p><p><b>RESULTS</b>Twelve trials involving 869 participants were included in the meta-analysis. Unified PD Rating Scale (UPDRS) I, II, III, IV scores and UPDRS V-IV total scores were used to be the primary outcomes, Parkinson Disease Question-39 (PDQ-39) and Scores of Chinese Medical Symptoms were the secondary outcomes. CM adjunct therapy had greater improvement in UPDRS I [2 trials; standardized mean difference (SMD)-0.40, 95% confidence interval (CI)-0.71 to-0.09; Z=2.49 (P=0.01)], II [5 trials; SMD-0.47, 95% CI-0.69 to-0.25; Z=4.20 (P<0.01)], III [5 trials; SMD-0.35, 95% CI-0.57 to-0.13; Z=3.16 (P=0.002)], IV scores [3 trials; SMD-0.32, 95% CI-0.60 to-0.03; Z=2.17 (P=0.03)], UPDRS I-IV total scores [7 trials; SMD-0.36, 95%CI-0.53 to-0.20; Z=4.24 (P<0.05)]. PDQ-39 and Chinese medical symptoms compared to the conventional medication only.</p><p><b>CONCLUSION</b>CM adjunct therapy has potential therapeutic benefits by decreasing UPDRS scores and reducing adverse effect.</p>
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Humans , Medicine, Chinese Traditional , Parkinson Disease , Drug Therapy , Publication Bias , Randomized Controlled Trials as Topic , Surveys and Questionnaires , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical effects of the circumcision stapler, circumcision cerclage, and traditional circumcision in the treatment of phimosis and redundant prepuce.</p><p><b>METHODS</b>Using the circumcision stapler (group A), foreskin cerclage (group B), and traditional circumcision (group C), we treated 276 patients with phimosis or redundant prepuce. We made comparisons among the three groups in the operation time, intraoperative blood loss, intraoperative and 24-hour postoperative pain scores, and incidence of postoperative complications. Results: The operation time, intraoperative blood loss, and intraoperative pain score were (6.52 ± 2.45) min, (1.93 ± 0.82) ml, and 1.37 ± 0.68 in group A and (7.24 ± 1.86) min, (1.51 ± 0.72) ml, and 1.20 ± 0.79 in group B, all significantly lower than (28. 36 ± 4.22) min, (9.52 ± 3.29) ml, and 3.06 ± 0.75 in group C (P <0.05). The 24-hour postoperative pain score was remarkably higher in group B than in A and C (3. 18 ± 0. 82 vs 1. 85 ± 0. 63 and 1. 82 ± 0. 75, P <0. 05). The incidence rate of postoperative complications was markedly lower in group A than in B (5. 43% vs 14. 13%, P < 0.05), but with no significant differences between either A and C or B and C (P >0.05).</p><p><b>CONCLUSION</b>The circumcision stapler, with its advantages of simple operation, minimal invasiveness, fewer complications, and better cosmetic result, deserves a wider clinical application.</p>
Subject(s)
Humans , Male , Blood Loss, Surgical , Circumcision, Male , Methods , Foreskin , Incidence , Pain Measurement , Pain, Postoperative , Diagnosis , Penis , Congenital Abnormalities , Phimosis , Therapeutics , Postoperative Complications , Postoperative PeriodABSTRACT
To evaluate the efficacy and safety of acupuncture combined with traction therapy for lumbar disc herniation, providing the basis for future research strategies. Randomized control trials. (RCT) of acupuncture combined with traction therapy for lumber disc herniation at home and abroad from 2000 to 2013 were searched, analysis and evaluation of literature and strength of evidence were based on the principles and methods of Evidence-based Medicine. The total effective rate and curative rate were considered as primary outcome measures; pain improvement, quality of life, relapse rate and adverse effects were considered as secondary outcome measures. Seventeen RCTs were identified, Meta-analysis showed that (1) total effective rate and curative rate: acupuncture combined with traction therapy was better than single therapy (acupuncture or traction); (2) pain improvement: acupuncture combined with traction therapy was better than traction therapy; (3) relapse rate: current evidence could not support the conclusion that acupuncture combined with traction therapy was better than traction therapy. Acupuncture combined with traction therapy for lumbar disc herniation was effective. However, the included studies were with high risk of bias, important outcome measures such as quality of life, relapse rate and adverse effects were not found in most of the studies. Current evidence has not yet been able to fully reflect acupuncture combined with traction therapy for lumbar disc herniation is better than single therapy, so more RCTs of higher quality are needed to further confirm its efficacy and safety.