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ObjectiveTo explore the comprehensive clinical value of Qianlieping capsules in the treatment of chronic prostatitis with damp-heat stasis syndrome， and to provide evidence for the decision-making of clinical basic drug management. MethodBased on the "Guidelines for Comprehensive Clinical Evaluation of Drugs （Trial Version 2021）"， this study systematically reviewed the existing research on the treatment of chronic prostatitis with damp-heat stasis syndrome by Qianlieping capsules. Based on evidence-based medicine， clinical epidemiology， clinical medicine， evidence-based pharmacy， pharmacoeconomics， health statistics， health technology assessment， and other disciplines， the multi-criteria decision analysis model （MCDA） and CSC 2.0 software were used. The six dimensions of safety， effectiveness， economy， innovation， suitability， and accessibility of drugs， as well as traditional Chinese medicine（TCM） characteristics， were comprehensively evaluated qualitatively and quantitatively. ResultIn terms of safety， based on the spontaneous reporting system （SRS） of the National Center for ADR Monitoring， safety literature analysis， pharmacological and toxicological experiment report， and other evidence， the safety grade of Qianlieping capsules was evaluated as grade A， with good safety. In terms of effectiveness， based on the results of pharmacological and pharmacodynamic studies and Meta-analysis， and combined with the value and quality of the evidence for efficacy， the final efficacy grade of Qianlieping capsules was rated as B. In terms of economy， Qianlieping capsules was a class B drug of national medical insurance. Compared with those of similar Chinese patent medicines， the average daily cost of Qianlieping capsules was moderate， and there was no related cost increase during the administration process. Economic research showed that Qianlieping capsules combined with α-receptor blockers were more economical than α-receptor blockers alone. Based on the quality evaluation of economic evidence and the value evaluation of economic evidence， the economic grade of Qianlieping capsules was rated as B. In terms of innovation， Qianlieping capsules were a combination of cold and warm drugs， focusing on clearing heat， detoxifying， removing blood stasis， and relieving pain， with non-toxic medicinal materials. They obtained a number of invention patents. The enterprise service system was perfect， and the quality standard was higher than the international and Chinese standards. The innovation grade of Qianlieping capsules was rated as B. In terms of suitability， the results of the questionnaire survey showed that it had relatively good suitability for clinicians， nurses， pharmacists， and patients who used Qianlieping capsules. The information on Chinese patent medicines was complete and met the requirements of national standards. The suitability grade of Qianlieping capsules was rated as A. In terms of accessibility， Qianlieping capsules were moderately priced and affordable， with sufficient resources of medicinal materials， no shortage of medicinal materials， and good availability. The accessibility grade of Qianlieping capsules was rated as B. In terms of TCM medicine characteristics， the prescription of Qianlieping capsules was derived from Danshen Huoxue Decoction. The original prescription was used for the treatment of chronic prostatitis with blood stasis syndrome. The whole formula was recorded in The Complete Compendium of Fine Formulas （《良方大全》） published by Beijing Publishing Group Co.， Ltd. in 1991 and has been used for more than 30 years. The formula was a combination of warm and cold drugs， attacking pathogens without hurting healthy Qi. The grade of TCM characteristics of Qianlieping capsules was rated as B. ConclusionBased on the above "6+1" dimensions， the comprehensive evaluation result of Qianlieping capsules in the treatment of chronic prostatitis with damp-heat and blood stasis syndrome is grade B， and it is recommended to convert it into the relevant policy results of basic clinical drug management according to the conditions.
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ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ2=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ2=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.
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ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ2=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ2=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.
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Facial autologous fat filling is widely accepted as a kind of facial cosmetic surgery.However, the postoperative complications, such as periorbital firm mass, ptosis and palpebral erythema, affect appearance and health seriously after surgery.Periorbital lipogranuloma is an ophthalmic complication of facial autologous fat filling which may be due to the nonviable adipocytes.The location of periorbital lipogranuloma is directly associated with fat filling site.The present therapies for periorbital lipogranuloma include the application of glucocorticoid and surgery.Most ophthalmologists in China know little about this disease, leading to misdiagnosis and overtreatment in clinical practice.This review summarizes the clinical characteristics of periorbital lipogranuloma in order to provide guidance for clinical diagnosis and treatment.
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Objective To explore the potential mechanism of action of estradiol benzoate on proliferation and differentiation of rat hippocampal neural stem cells.Methods Hippocampus tissues from SD rats were dissociated and plated into culture flasks.Neural stem cells were identified by immunofluorescence against Nestin.After treatment with different concentration of estradiol benzoate (10-10,10-9,10-8,10-7,10-6 mol/L),the proliferation and differentiation of neural stem cells were assessed by MTT assay and the proportion of neurons and astrocytes in differentiated cells was assessed by flow cytometry.Western blot assay was performed to detect the expression levels of protein in neural stem cells.Results (1) The neural stem cells formed neurospheres and grew in floating,and were Nestin-positive.Estrogen receptors,including ERα and ERβ,were expressed in neural stem cells;(2)After treatment with 10-8 mol/L estradiol benzoate versus in the control group,the cell viability was significantly increased (t =5.36,P =0.003),and the ratio of neuron-specific nuclear protein(NeuN)-positive neuron cells in total cells was significantly increased (t =4.32,P =0.02),but the ratio of glial fibers acidic protein(GFAP)-positive cell in total cells was decreased(t=4.65,P=0.008).The expression levels of GDNF,GFRal and Ret proteins were enhanced in the estradiol benzoate group compared with the control group.Conclusions Appropriate concentration of estradiol benzoate promotes proliferation and differentiation ofin vitrocultured hippocampal neural stem cells and elevates the ratio between neurons and glial cells differentiated from neural stem cells.
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Objective To study adipose-derived stem cells (ADSCs)differentiation into endothelial cells and smooth muscle cells by induction with supernatant liquid from cerebral infarction tissue in rats.Methods The ADSCs were obtained from retroperitoneal adipose tissue of rats and identified by flow cytometry technology.The normal brain tissues and the infarcted cerebral tissue obtained from rats with middle cerebral artery occlusion were used to induce ADSCs differentiation,and no intervention group was as a control.The mRNA expression level of von willebrand factor (vWF),α-smooth muscle actin (α-SMA) and smooth muscle myosin heavy chain (SM-MHC) in cells after induction were detected using reverse transcriptase-polymerase chain reaction.Immunofluorescence were used to identify the expression of endothelial cells markers and smooth muscle cell markers,and positive expression cell was detected by fluorescence microscope.Results On the ADSCs surfaces,the high expressed-positive antigens included CD90 (96.7％),CD29 (84.4％),CD44 (98.9％),and the low expressed negative antigens included CD45 (6.5％),CD34 (7.4％) and CD31 (3.6％).Compared with no intervention group and normal brain tissue of supernatant liquid group,the cerebral infarction tissue of supernatant liquid-induced group showed the increased mRNA expression level of vWF,α-SMA and SM-MHC(F=5.962,6.756,6.144,P=0.001,0.004,0.003),and showed that the immunofluorescence indicated-cell expression level of vWF,α-SMA and SM-MHC was much more increased (all P ＜ 0.05).Conclusions Under the induction by supernatant liquid of cerebral infarction tissue,ADSCs highly expresses the markers of endothelial cells and smooth muscle cells.This suggests that the cerebral infarction tissue of supernatant liquid-induced ADSCs have a tendency to differentiate into endothelial cells and smooth muscle cells.
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Background Juvenile Graves ophthalmopathy has a low prevalence and few relevant studies.Analyzing and reviewing the clinical features and therapeutic effectiveness of juvenile Graves ophthalmopathy is helpful to its diagnosis and management.Objective This study was to evaluate the clinical characteristics of Graves ophthalmopathy and its management in children and adolescents.Methods The clinical data of 54 eyes from 29 patients with Graves ophthalmopathy who were diagnosed in Shanghai Changzheng Hospital from January 2007 to December 2012 were retrospectively analyzed.The ocular manifestations,thyroid function,CT or MRI testing results were collected,and the activity of Graves ophthalmopathy was scored based on the criteria of CAS.Artificial tears was topically administered in 44 eyes with CAS ≤ 2.In the eyes with CAS ≥ 3,corticosteroids drug was systemically used in 3 patients,and orbital decompression surgery and excision of Müller muscle were performed in 3 eyes of 2 patients respectively.The follow-up was carried out for 1.5-6 years.The treatment outcomes were evaluated according to the reduction of exophthalnos and the improvement of upper eyelid retraction.Results The patients were 5-18 years old with an average age of 12.9 years old.Out of 29 Graves ophthalmopathy patients,5 males and 24 females were included.The initial clinical manifestations were proptosis,eyelid retraction and swelling,and accompanied by conjunctival congestion and hypophasis.The best corrected visual acuity (BCVA) was ≥ 0.8 in all the eyes.CAS scores wcre 0-2 in 48 eyes of 26 patients and ≥ 3 (active Graves ophthalmopathy) in 6 eyes of 3 patients.The increase of orbital adipose volume was exhibited in all the eyes and the enlargement of extraocular muscle was revealed in parts of eyes by CT/MRI.Laboratory examination showed normal thyroid function in 12 patients (41.4％),hyperthyreosis in 15 patients (51.7％) and hypothyroidism in 2 patients (6.9％).The ocular symptom was improved in 20 eyes of 11 patients (37.9％),stabilized in 29 eyes of 16 patients (55.2％) and worsen in4 eyes of 2 patients (6.9％) in following-up duration.Conclusions Graves ophthalmopathy occurs much more in female than in male.The clinical manifestations are mild,with low activity and good prognosis in children and adolescents Graves ophthalmopathy.
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Background Transscleral diode laser cyclophotocoagulation (TDCP) was used to later stage of glaucoma in the past.However,the indications of TDCP are expanding gradually over time and there are more and more reports about its application in different stages and different types of glaucoma.Objective This study was to compare the clinical efficacy of TDCP and trabeculectomy for primary acute angle-closure glaucoma (PAACG) with persistent ocular hypertension.Methods Ninety-five PAACG patients with persistent ocular hypertension were retrospectively analyzed.The patients were divided into TDGP group (62 eyes of 56 cases) and trabeculectomy group (44 eyes of 39 cases) based on the difference of treating fashions.The clinical outcomes were compared between the two groups with the evaluating indexes of visual acuity,intraocular pressure (IOP) before and 1 week,3 months and the end of following-up as well as the number of drug used and the re-treatment.Results The demography was matched between the two groups (all at P＞0.05).The number of eyes with visual improvement was significantly different among the groups (x2 =30.927,P =0.002) in the TDCP group.Compared with before treatment,the number of visual improvement in 1 week after treatment was significantly raised (x2 =16.778,P =0.002).No significant differences were seen in the eye number of visual improvement in various timepoints after treatment (all at P＞0.008).Also,the eye number of visual improvement was significantly different among the different timepoints (x2 =44.345,P＜0.001),and statistically significant change was found between the preoperation and postoperative 1 week (x2 =23.725,P＜0.001).However,there were no significant differences in the eye number of visual improvement in various timepoints after operation each other (all at P＞0.008).The IOP was insignificantly altered among the groups at various timepoints (Fgroup =3.836,P =0.053),but the change was significantly different over time (Ftime =757.078,P＜0.001).The postoperative IOP was significantly higher than that of preoperation in both groups (all at P＜0.001).The proportion of eyes using lowering-IOP drugs was 48.4％ in the TDCP group,and that in the trabeculectomy group was 27.3％,showing a significant difference between them (x2 =4.796,P =0.029).The retherapy was performed in 20 eyes (32.3％) and 2 eyes (4.5％) in the TDCP group and the trabeculectomy group,respectively.Conclusions The short-term lowing-IOP effecacy of TDCP is similar to trabeculectomy,but the longterm lowing-IOP efficacy of TDCP is not good.Compared with the trabeculectomy,TDCP shows more simple operation,less time-consuming during the surgery and milder tissue damage,but the eyes continuing to use anti-glaucomatous drugs or re-therapy are increased.
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An 81-year-old man with hemangiopericytoma had clinically conspicuous manifestation of a first slowly then rapidly growing, painless, and sublobe-like mass in the left orbit, proptosis, massive bleeding, and underwent orbital exenteration with keeping the eyelids. The tumor reoccurred 21 months after the operation and the patient had prolonged, serious hemorrhage in the left orbit and died of brain metastasis six months later. The etiology and inducement factors were unknown, but it is suspected that the fatal family casualty might be a more important inducement than trauma for this patient
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Humans , Male , Aged, 80 and over , Hemangiopericytoma/pathology , Orbital Neoplasms/pathology , Hemangiopericytoma/mortalityABSTRACT
MicroRNAs (miRNA), an abundant class of highly conserved small non-coding RNAs, suppress gene expression by binding to the 3' UTR of target mRNAs, which presents an entirely new approach to post-transcriptional regulation of gene expression. MiRNAs have been shown to play key roles in the regulation of diverse biological processes, such as development, inflammation, apoptosis, and tumorigenesis. Several studies have shown the dysregulated miRNAs in various lymphomas including the overexpression of miR-106a and miR-17-92 in T cell lymphoma;upregulated miR-155, miR-221 and miR-21 in diffuse large B-cell iymphoma and follicular cell lymphoma, and these miRNAs associated with subtypes of diffuse large B-cell lymphoma. Overexpression of the miR-17 cluster showed reduced levels of apoptosis, suggesting that the main effect of these miRNAs was to suppress cell death. Although miRNAs can act as both tumour suppressor and oncogenic molecules, the mechanistic explanation for this dysregulation is unclear but maybe linked to the defects in the miRNA biosynthetic machinery. As more evidence accumulates, it is likely that miRNAs will emerge as a new class of epigenetic regulator.
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As a frontier branches of science,a significant progress in orbital diseases has been achieved in the last several years.In view of the existing problems in current teaching mode for experts in orbital diseases and their characteristics,a series of initiatives for researching a new mode have been taken,and some achievements have been made.
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There are some characteristics in ophthalmology teaching for students of seven-year program,such as ophthalmological theory teaching,teaching materials selection,clinical effective teaching methods,and research training methods.In view of the existing problems in current ophthalmology teaching mode for seven-year program,a series of initiatives for researching a new mode has been taken,and some achievements have been made in these fields by exploring some effective teaching methods and practice.
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Objective The analysis of hospitalization expenses contributes to effective measures for reducing medical costs.The authors investigated the hospitalization expenses and the influencing factors in orbital cavernous hemangioma (OCH) patients in Shanghai Changzheng Hospital.Methods In view of clinical diagnosis and treatment and social economics,we conducted a single factor analysis and a stepwise multiple linear regression analysis on the influencing factors of the hospitalization expenses of 81 OCH patients from 2002 to 2007.Results The six-year hospitalization expenses of the OCH patients averaged RMB $7 071.4 and the median was RMB $7 038.7,with the costs of surgical materials (54.3%),Western medicine (13.3%) and laboratory examinations (8.1%) as the top three figures.The single factor analysis and stepwise multiple linear regression analysis showed 8 factors to be statistically significant in influencing the hospitalization expenses of the OCH patients,namely,marital status,occupation,complications,anterior orbitotomy,previous treatment,proptosis,hospitalization year and preoperative hospital stay (P
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By relating the construction of orbital diseases’ resources bank,the clinical data became useful teaching resources.This paper introduces the construction requirements,its application in teaching for experts in orbital disease and some problems to be solved.
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As a frontier branches of science,a significant progress in orbital diseases has been achieved in the last few years.In view of the existing problems in current teaching mode for experts in orbital disease and their characteristics,a series of initiatives for researching a new mode have been taken,and some achievements have been made.
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AIM: To evaluate the safety and efficacy of loteprednol for controlling of ocular inflammation. METHODS: Data from 8 relevant monographs were retrieved by means of computerized and manual search. The combined analysis of the data was assessed in terms of clinical and statistical criteria, and the data were extracted and synthesized by using the statistical techniques of meta-analysis. Treatment effects and safety of loteprednol were through counting as risk difference between treatment and control groups. The estimates of pooled risk differences were computed according to a random-effects model. RESULTS: A total of 1 660 patients were included in this meta-analysis. Pooled risk differences of intraocular pressure elevation were 1 % (95 % CI, -1 %, 3 %) compared with placebo, -5 % (95 % CI, -9 %, 0 %) compared with prednisolone, respectively. Compared with placebo, pooled risk differences of inflammation improvement were: 31 % (95 % CI, 22 %, 40 %) of postoperative inflammation, 28 % (95 % CI, 19 %, 37 %) of seasonal allergic conjunctivitis, and 26 % (95 % CI, 18 %, 35 %) of giant papillary conjunctivitis, respectively. Compared with prednisolone, pooled risk differences of inflammation improvement of acute anterior uveitis was -15 % (95 % CI, -25 %, -4 %). CONCLUSION: Loteprednol is a safe and effective corticosteroid in controlling ocular inflammation such as postoperative inflammation, seasonal allergic conjunctivitis, giant papillary conjunctivitis, and acute anterior uveitis.
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Objective To detect and analyse the mutations in rhodopsin gene of members in a family affected by autosomal dominant retinitis pigmentosa (ADRP). Methods Using the polymerase chain reaction (PCR), we amplified exon 1-5 of rhodopsin gene in patients with ADRP,and analyzed it with direct sequence measuement. Results The Gly-182-Asp mutation in the rhodopsin gene was detected in most of affected members of this ADRP family, but no mutation was detected in two affected members and the control ones. Conclusion We cannot regard the Gly-182-Asp mutation in the rhodopsin gene as the pathagenic factor of the ADRP family. It is likely there is a new gene next to the rhodopsin gene.
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Objective:To prepare fluorouracil-loaded chitosan nanoparticle (5-Fu-CS-NP) for ophthalmologic usage and evaluate its releasing characteristics in vitro. Methods: 5-Fu-CS-NP was prepared with 5-Fu, polyacrylic acid and chitosan using dispersion method. The mean size, entrapment efficiency (EE%), drug loading (DL%) and the in vitro releasing characteristics of 5-Fu-CS-NP were investigated.Results and conclusion: The mean size of 5-Fu-CS-NP was (144.6?3.1) nm, the EE% was 84.5% and the DL% was 3.91%. 5-Fu-CS-NP had a satisfactory sustained-releasing effect and the releasing could last for 3-7 days, and the release behavior was not greatly changed within a pH value of 7.2-7.4.
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B-ultrasonography and/or CT scannings of 84 cases of enlarged superior ophthalmic vein (SOV) were analysed morphologically and etiologically. Carotid-cavernous fistula, ophthalmic Graves disease, Tolosa-Hunt syndrome, orbital vascular deformity, inflammation at the apex of the orbit, orbital pseudo tumor, intraorbital hematoma and thrombosis of the SOV might induce enlargement of SOV. Associated with other Findings of intraorbital tissues revealed by CT and B-ultrasonography, the etiological diagnosis of the enlarged SOV could be made. The dynamic findings of the SOV rendered by B-ultrasonography and Doppler ultrasonic play an important role in the diagnosis of carotid-cavernous fistula.
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The mucosa associated lymphoid tissue(MALT) lymphoma represents a distinct subgroup of B cell non Hodgkin lymphomas (NHL) arising from extranodal sites. These neoplasms usually arise from the gastrointestinal tract,salivary gland,thyroid and ocular adnexal, which have been recognized from clinical,pathological and molecular genetics aspects.In this paper we reviewed the investigation progress of MALT lymphoma molecular biology.