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OBJECTIVE@#To compare the clinical efficacy and safety among three different entry points of needle knife, including tenderness point, intervertebral foramen point and articular process node, for lumbar disc herniation (LDH).@*METHODS@#A total of 105 patients with LDH were randomly divided into a tenderness point group (35 cases, 1 case dropped off ), an intervertebral foramen point group (35 cases) and an articular process node group (35 cases, 1 case dropped off ). In the three groups, the needle knife was given at positive tenderness points of lumbosacral and hip, the external point of intervertebral foramen and the node of vertebral joint process respectively, once a week for a total of 4 times. The scores of Japanese Orthopaedic Association (JOA), Oswestry disability index (ODI), visual analogue scale (VAS) were recorded before treatment, 2 weeks and 4 weeks into treatment, and 3 months follow-up after treatment, and the clinical efficacy and safety was observed.@*RESULTS@#Compared before treatment, the JOA scores in each group were increased 2, 4 weeks into treatment and in the follow-up (P<0.05); 4 weeks into treatment and in the follow-up, the JOA scores in the tenderness point group and the articular process node group were higher than those in the intervertebral foramen point group (P<0.05). Compared before treatment, except for ODI score 2 weeks into treatment in the intervertebral foramen point group, the ODI and VAS scores in each group were decreased 2, 4 weeks into treatment and in the follow-up (P<0.05), and the ODI scores in the tenderness point group and the articular process node group were lower than those in the intervertebral foramen point group (P<0.05). In 2 weeks into treatment, the VAS scores in the tenderness point group and the articular process node group were lower than those in the intervertebral foramen point group (P<0.05); in 4 weeks into treatment and follow-up, the VAS scores in the tenderness point group were lower than the other two groups (P<0.05). After treatment, the clinical efficacy of each group was similar (P>0.05); during the follow-up, the total effective rate in the tenderness point group was higher than that in the intervertebral foramen point group (P<0.05). There were no serious adverse events in each group.@*CONCLUSION@#The three different entry points of needle knife all could improve the symptoms of patients with LDH. The comprehensive effect of improving the subjective symptoms, lumbar function, pain degree and long-term curative effect is better in the tenderness point group.
Subject(s)
Humans , Intervertebral Disc Displacement/therapy , Lumbar Vertebrae , Lumbosacral Region , Retrospective Studies , Treatment OutcomeABSTRACT
Genomic instability is one of the most pervasive characteristics of cancer cells,and DNA damage response (DDR) pathway plays a crucial role in genomic stability.The DDR pathway is a complex signaling network,which involves cell DNA repair,apoptosis and cell cycle regulation.Deficiencies in these repair pathways can result in several different genetic disorders,including cancer.Targeted therapy based on inhibiting the DDR pathway in cancers offers a novel therapy strategy for patients with tumors lacking specific DDR functions.Many small-mole-cule compounds targeting DDR pathway are typically developed for solid cancer therapy.The poly (ADP-ribose) polymerase (PARP) inhibitor is a kind of DDR inhibitors which exploits the principle of synthetic lethality to selectively kill cancer cells.This review highlights the molecular mechanisms of PARP inhibitor action,the progress of PARP inhibitors in cancer therapy,drug resistance and the challenge of PARP inhibitor in the future.
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To provide accurate information on geographic distribution of crude drug Sailonggu in the plateau, we identified zokor species (Eospalax spp.) in Qinghai-Tibet Plateau using molecular methods. Based on the mitochondrial cytochrome B (cytb) gene sequences, we then extracted haplotypes from these sequences and reconstructed phylogenetic trees for the haplotypes using both maximum likelihood (ML) and Bayesian inference (BI) methods. Based on the trees, the species of each sample were determined. Five hundred and three samples from 35 populations were sequenced and their whole cytb sequences (1140 bp) were obtained. From these sequences 150 haplotypes were detected, in which, 126 were Eospalax baileyi, 20 were E. cansus, and 4 were E. smithi of the 35 populations, 28 were E. baileyi type, 5 were E. cansus type, and the remaining 2 were mixed of E. baileyi + E. cansus (DT2) and E. baileyi + E. smithi (ZN3). The results showed that, the regions around the Qinghai lake and near the upper stream of Yellow River started at Guide could be viewed as the producing area of authentic Sailonggu, and also, the cytb gene is a powerful molecular marker to determine the species of zokors as well as for the authentication of geographic distribution of Sailonggu.
Subject(s)
Animals , Bone and Bones , Metabolism , Haplotypes , Medicine, Tibetan Traditional , Phylogeny , Rodentia , Classification , GeneticsABSTRACT
Background As a newly developed refractive surgery,femtosecond laser in situ keratomileusis (LASIK) receives more and more attention.Changes in ocular stray light after femtosecond LASIK is an important problem that impacts visual quality.Some relevant research has been performed before,but the outcomes are conflicting.Objective This primary study was to investigate the change of stray light values before and after femtosecond LASIK and analyze the relevant factors underlying the change.Methods Clinical data from 109 eyes of 55 myopic patients who underwent femtosecond LASIK in Tianjin Eye Hospital from December,2010 through February,2011 were included in this study.Stray light values were measured and recorded by C-Quant stray light meter preoperatively,and 1 day,1 week,1 month and 6 months postoperatively.The stray light data were compared by repeated measures ANOVA,and the correlations among the stray light values with preoperative factors,such as age,equivalent sphere,pupil diameter and central corneal thickness(CCT),as well as with postoperative factors,such as residual bed thickness(RBT),RBT/CCT,ablation depth,ablation ratio,flap thickness,flap diameter flap base width and exiting energy,were analyzed statistically.Written informed consent was obtained from each individual at initial of this study.Results The stray light values were 0.90±0.19,1.10±0.19,1.02±0.18,0.96±0.16 and 0.94±0.15 pre-operation,and 1 day,1 week,1 month and 6 months after femtosecond LASIK.The stray light values increased significantly 1 day,1 week,and 1 month after surgery,showing significant differences among the various time points (F=17.699,P=0.000).The mean stray light value was higher in 1 week than that in 6 months after operation (t=2.412,P=0.017).No significant differences were found in the stray light values between 6 months and 1 month or pre-operation (t =0.779,P =0.437 ; t =-1.877,P =0.062).No significant correlations were seen between preoperative and postoperative stray light values with age,preoperative refractive diopter,pupil diameter or CCT (P＞0.05).The changes in stray light values 1 week,1 month and 6 months after surgery were negatively correlated with ablation depth(r=-0.226,-0.228,-0.241 ;P＜0.05) and ablation ratio(r =-0.149,-0.219,-0.255 ;P＜0.05).Conclusions Stray light values increase within 1 month and return to normal 6 months after femtosecond LASIK.Stray light values may be related to multiple setting laser parameters and factors during femtosecond LASIK.
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Background Laser in situ keratomileusis (LASIK) is frequently performed to reduce or eliminate myopic refractive error.Some patients complain of a loss of visual function after surgery even when they have 20/20 visual acuity.One of the reasons is the change of asphericity of the cornea.Objective This study attempts to investigate the short-term changes of the anterior and posterior corneal asphericity after LASIK.Methods One hundred and seven myopic eyes of 54 subjects with the equivalent spherical diopter of -1.30 to -7.50 D who have received LASIK were enrolled in this prospective study.The Q-values of the posterior corneal surface for different corneal diameters (6mm,7mm,8mm and 9mm) were measured with Pentacam preoperatively and 1 month postoperatively.The correlations between Q-value,Q change (△Q),and the mean preoperative spherical equivalent refraction (SE),central corneal thickness (CCT),central ablation depth (AD) and residual bed thickness were investigated.Written informed consents were obtained from all the subjects prior to the clinical trial.Results The Q-values of the anterior and posterior corneal surfaces gradually decreased to negative values with the increase of corneal diameter in myopic eyes.Weak correlations were found between the asphericity of the anterior and posterior corneal surfaces from diameters of 6mm,7mm,8mm and 9mm (r=0.227,0.288,0.303,0.389;P=0.019,0.003,0.002 and 0.000,respectively).No statistically significant correlation was found between Q-value and the diopter of refractive error (P＞0.05).Both the anterior and posterior corneal Q-values varied toward the positive direction except that in the 9mm area of the posterior corneal surface at postoperative 1 month(t=-1.495,P=0.138).The increase of the anterior corneal asphericity (△Q) was more obvious than that of the posterior corneal surface and showed a positive correlation with ablation depth and a negative correlation with residual bed thickness.However,no statistically significant correlation was seen between △Q and these two parameters in the posterior corneal surface (P＞0.05).Conclusion The shape of the anterior and posterior corneal surface shows more prolateness as the increase of corneal diameter in myopic eyes.Both the anterior and the posterior corneal surfaces have an oblate shift within the ablation zone 1 month after LASIK.
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<p><b>BACKGROUND</b>The recent studies have shown that visual performance might be affected by the ocular aberration after the corneal refractive surgery, and try to minimize it. This study was to investigate the effects of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) on the higher order of wavefront aberration and analysis of their characteristics.</p><p><b>METHOD</b>This prospective study involved 32 eyes with similar refractive powers (-5.0 D to -6.0 D preoperatively). LASIK and PRK were performed with the same parameters of 6 mm diameter optical zone and 7 mm diameter transition zone ablation. Wavefront aberrations were tested using a ray tracing technique preoperatively and 3 months postoperatively. Three measurements were obtained for each condition; the root mean squared wavefront error (RMS), values for overall wavefront aberrations and each order of the Zernike aberrations were analyzed using the Matlab software. The 2-tailed t test was used for statistical analysis.</p><p><b>RESULTS</b>Overall higher order aberrations were increased from (0.550.26) microm preoperatively to (0.930.37) microm for PRK and (0.790.38) microm for LASIK postoperatively. This was a 1.69 fold increase in the PRK group (t = 3.95, P < 0.001) and a 1.43 fold increase in the LASIK group (t = 2.60, P < 0.05). At 3 months, the mean RMS value for higher-order (3rd to 6th) were significantly increased compared with the corresponding preoperative values (P < 0.05). The fourth order aberrations, spherical like aberration, were dominant by a 2.64 fold in PRK and a 2.31 fold in LASIK. Different influences of the PRK group and LASIK group were shown in the various zernike components. The statistically significant differences were seen in C(4)(0), C(4)(+4), C(5)(+1), C(5)(+3), C(5)(+5) and C(6)(+2) of the PRK group and C(3)(-3), C(4)(0), C(5)(-5), C(5)(+5), C(6)(-2) of the LASIK group, which represents a 7.42, 3.58, 9.21, 2.72 and 5.3 fold increases in PRK group, and 6.40, 10.80, 11.06, 3.47 and 6.09 fold increases in LASIK group, respectively. C(3)(-3) in LASIK was higher and C(5)(+1) and C(5)(+3) were lower than those in the PRK group. C(4)(0) (spherical aberration) values were similar between PRK and LASIK, however, C(3)(-1) and C(3)(1) (coma) in LASIK were higher than those in PRK, but these differences are of no statistical significance.</p><p><b>CONCLUSIONS</b>PRK and LASIK may increase ocular higher-order aberrations, but they both have their own features. The difference between the two types of surgery may be correlated with the change of the corneal shape, the conversion of biodynamics, the healing of the corneal cut, and re-structured corneal epithelium and/or the stroma.</p>
Subject(s)
Adolescent , Adult , Humans , Cornea , Pathology , Keratomileusis, Laser In Situ , Lasers, Excimer , Photorefractive Keratectomy , Postoperative Complications , Prospective Studies , Vision Disorders , Visual AcuityABSTRACT
Cholelithiasis is one of the clinically common and frequently encountered diseases. In this paper, the Chinese Meteria Medica and prescriptions utilized to treat cholelithasis were discussed in four aspects. In addition, we discussed the clinical effect and mechanism of actions of these drugs in order to provide some reference for future drug development in this area.