Rivaxaban combined with antiplatelet drugs in ischemic stroke patients with atrial fibrillation and intracranial artery stenosis: comparison with rivaroxaban alone / 国际脑血管病杂志

Objective:To investigate the efficacy and safety of rivaroxaban combined with antiplatelet in ischemic stroke patients with non-valvular atrial fibrillation and moderate or severe intracranial artery stenosis.Methods:The consecutive ischemic stroke patients with non-valvular atrial fibrillation and moderate or severe intracranial artery stenosis admitted to Yantai Yuhuangding Hospital of Qingdao University from August 2019 to March 2022 were retrospectively included. According to the secondary prevention drugs, the patients were divided into rivaroxaban and rivaroxaban combined with antiplatelet treatment group. The basic characteristics of the two groups were compared. The primary outcome was the recurrence rate of stroke at 3 months, and the secondary outcome included the incidence of any bleeding event at 3 months, the all-cause mortality rate, the improvement rate of neurological function, and the good outcome rate. The good outcome was defined as the modified Rankin Scale ≤2 points at 3 months.Results:A total of 108 patients aged 70.72±8.08 years old were included in the study. There were 56 patients (51.9%) in the rivaroxaban group and 52 (48.1%) in the combined treatment group. In terms of primary outcome, the recurrence rate of stroke in the combined treatment group was significantly lower than that in the rivaroxaban group at 3 months (7.69% vs. 21.43%; P<0.05). In terms of secondary outcomes, the incidence of bleeding events in the combined treatment group at 3 months was significantly higher than that in the rivaroxaban group (26.92% vs. 7.14%; P<0.05), with one death event in each group. The rate of good outcome in the combined treatment group was significantly higher than that in the rivaroxaban group (75.00% vs. 51.79%; P=0.013). Multivariate logistic regression analysis showed that high National Institutes of Health Stroke Scale (NIHSS) score at admission was an independent risk factor for poor outcome (odds ratio 1.370, 95% confidence interval 1.057-1.776; P=0.018), while the rivaroxaban combined antiplatelet treatment was an independent protective factor for stroke recurrence (odds ratio 0.203, 95% confidence interval 0.054-0.758; P=0.018). Conclusion:After ischemic stroke in patients with non-valvular atrial fibrillation complicated with moderate and severe stenosis of intracranial artery, rivaroxaban combined with antiplatelet treatment can reduce the recurrence rate of stroke and improve the clinical outcome, but it may increase the risk of bleeding.

The analysis of the correlation of tympanic injection of triamcinolone acetonide and middle ear pressure after radiotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the correlation of the tympanic injection of triamcinolone acetonide, middle ear pressure (MEP) and radioactive secretory otitis media (RSOM) with nasopharyngeal carcinoma (NPC) after radiotherapy.@*METHOD@#Fifty-two patients suffering NPC without otitis media before radiotherapy were randomly divided into three groups. 17 cases with 34 ears were distributed into treatment group I, and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-7 weeks 1 times a week. Treatment group I had 17 cases with 34 ears,and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-12 weeks 1 times a week. And control group consisted of 18 cases with 36 ears who didn't accept such treatment. In all 104 ears, MEP was tested at the begin of radiotherapy and the end of 1st, 2nd, 3rd month after radiotherapy.@*RESULT@#From the beginning of radiotherapy to the end of th 1st, 2nd, 3rd month after radiotherapy, the morbidity of RSOM gradually increased and MEP decreased in the treatment group I , II and the control group, in which treatment group II showed the lowest morbidity of RSOM and MEP was maximum (P 0.05).@*CONCLUSION@#Tympanic injection of triamcinolone acetonide could reduce radiation injury, and medication time was positively correlated with the MEP, and a negative correlation with RSOM morbidity, and the longer treatment, the more significant the effect is. The difference is most obvious at the end of 3rd month after radiotherapy. It may be due to the more active repairation after radiation damage in middle ears, but long-term efficacy must continue to observe.

Effects of different doses of 60Co γ-ray irradiation on apoptosis of rat submandibular gland cells / 中国医师杂志

Objective To explore effects of different doses of 60Co γ-ray irradiation on apoptosis of rat submandibular gland dells.Methods Wistar rats were randomly divided into four different radiotherapy dosage groups (0 G y,7.5 G y,15 Gy,and 22.5 Gy).Rats in each radiotherapy groups were irradiated by the required dose of γ-ray irradiation (0 Gy,7.5 Gy,15 Gy,22.5 Gy) at one time.Immunohistochemistry method and TdT-mediated dUTP nick end labeling (TUNEL) methods were used to detect expression of P53,caspase-3,and apoptosis of submandibular gland dells in rats.Results The expression levels of P53 and caspase-3 of rat submandibular cells were significantly increased in different radiotherapy dosage groups (7.5 G y,15 Gy,and 22.5 Gy) relative the 0 Gy dosage group.The apoptotic cells were more commonly seen in duct cells in different radiotherapy dosage groups,and the apoptotic cells were gradually increased with the increased radiotherapy dosages.Conclusions 60 Co γ-ray irradiation could lead to apoptosis of rat submandibular gland in the early stage.There is a dose-effect relationship between 60Co γ-ray irradiation and induced apoptosis of rat submandibular gland cells.

The effects of tea polyphenols and Laminaria japonica polysaccharides on nasopharyngeal carcinoma cell HONE1 and CNE2 / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the effects of laminaria japonica polysaccharides(LJP) and tea polyphenols (TP) on nasopharyngeal carcinoma(NPC) cells HONE1 and CNE2, and further to explore the underlying mechanism of antitumor activity of LJP on NPC cell in vivo.@*METHOD@#To identify the logarithmic growth phase of NPC cells HONE1 and CNE2 through cell growth curve and doubling time by means of MTT, then inhibition of the cells proliferation were detected with LJP and TP separately and combined. With LJP treatment, cell apoptosis of HONE1 was examined by double staining assay. A tumor model,established by subcutaneously inoculation of NPC cell HONE1 into nude mice,was used to evaluate the inhibitory effect of LJP in vivo.@*RESULT@#Both LJP and TP had inhibition effect on two groups of cell proliferation, and LJP and TP combined effect of inhibition were higher than the two separate on two sets of experimental cell proliferation, whose effect was concentration-dependent. LJP could induce apoptosis of HONE1. With the increasing concentration of LJP, apoptosis rate increased. The apoptosis rate was(49.51 +/- 1. 89) % (P0. 05).@*CONCLUSION@#LJP and TP can inhibit the proliferation of NPC cells HONE1 and CNE2 respectively,and combined use has a significant effect. LJP can inhibit the growth of NPC probably by inducing apoptosis of NPC cells in vitro and in vivo.

A review for a traditional Chinese medical journal Shou Shi Yi Bao / 中西医结合学报

Shou Shi Yi Bao was a journal of traditional Chinese medicine (TCM) during the period from 1935 to 1937, and was originated by Chen Huan-yun, a TCM physician in Suzhou. It is mainly to transmit the knowledge of TCM and to promote the epidemic prevention capacity of local public. The editorial characteristics and historical value of the journal were explored in initial background, staff writers, editorial policies, contents and the Editor Chen's medical ideas. Shou Shi Yi Bao was supported by many famous TCM physicians, although the journal was originated from the civil society. It was an academic TCM journal with perfect practicability for orientating to the public and highlighting the academic spirit. Chen Huan-yun was a resolute defender of TCM, and had many opinions on clinical practice and lots of scientific suggestions on TCM development. Shou Shi Yi Bao reflected the main characteristics of TCM journals in 1930s. The journal was one of the important documents to study the TCM history during the period of the Republic of China in Jiangsu Province, and it also set a stage for the struggle between TCM and Western medicine at that time. The documentary information of the journal has literature and history values in reflecting the historical process of TCM self-improvement. The success of the journal was due to not only the broken-up sectarian bias and cooperation of the TCM practitioners but also the preponderant geographic and cultural circumstances of Suzhou as well as Chen Huan-yun's profound knowledge in traditional Chinese culture and medicine.

Situation of epidemic prevention in the late Qing dynasty in Shanghai / 中西医结合学报

To study the implementation of the epidemic prevention by the authorities of the concession and late Qing dynasty through investigation of the prevention and treatment of pestilence in Shanghai from 1872 to 1911, this paper analyzes the issues concerning municipal administration, inspection and disinfection, food sanitation, vaccination, regulatory legislation and health promotion, etc. The experiences are summarized in the study. The lessons drawn from what the concession authority did to prevent pestilence imply that the implementation of health promotion should be carried out according to the variation of the time, location and population, and that traditional Chinese medicine should be involved in the prevention and treatment of pestilence.

The clinical use of midfacial degloving and modified hemifacial degloving approach associated with nasal endoscopy surgery in nasal surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the method and effect of the midfacial degloving approach and modified hemifacial degloving approach associated with nasal endoscopic surgery in the treatment of the nasal diseases.@*METHOD@#Thirty patients with nasal diseases were treated with nasal endoscopic surgery by midfacial degloving approach and modified hemifacial degloving approach. Four cases underwent midfacial degloving approach with standard method, three cases were underwent by hemifacial degloving approach and our modified hemifacial degloving approach associated with nasal endoscopic surgery were performed in twenty-three cases. We used Caldwell-Luc's approaches which located mainly in affected-side, and modified bilateral intercartilaginous incision, which at first peeled off integrality healthy-side cutis and mucosa of nasal septum as well as periosteum of basis nasi. With preserving the integrality of the healthy-side nasal cavity parenchyma, the pyriform aperture incisions extending to the healthy-side vestibule wasn't been cut. With the incisions of septal cartilage of nasal and disease- side cutis and mucosa of nasal septum as well as the pyriform aperture incisions extending to the affected-side vestibule, the lesion were cleared away completely by modified midfacial degloving approach associated with nasal endoscopic surgery.@*RESULT@#All cases cuts achieved primary healing. One of four cases with midfacial degloving approach suffered from straightness of nasal vestibule. One of three cases with hemifacial degloving approach was led to perforation of nasal septum. In 23 cases operated hy modified hemifacial degloving approach, no straightness of nasal vestibule and no perforation of nasal septum was happened.@*CONCLUSION@#The midfacial degloving approach and modified hemifacial degloving associated with endoscopic surgery can achieve the advantages of a widely exposed field for operation, no facial scar, making tumour resection easier, and also no nasal- stuffed in healthy nasal cavity as well as no straightness of nasal vestibule after modified approach.