Network meta-analysis comparing the clinical outcomes and safety of robotic, laparoscopic, and transanal total rectal mesenteric resection for rectal cancer / 中华胃肠外科杂志

Objective: To methodically assess the clinical effectiveness and safety of robot-assisted total rectal mesenteric resection (RTME), laparoscopic-assisted total rectal mesenteric resection (laTME), and transanal total rectal mesenteric resection (taTME). Methods: A computer search was conducted on PubMed, Embase, Cochrane Library, and Ovid databases to identify English-language reports published between January 2017 and January 2022 that compared the clinical efficacy of the three surgical procedures of RTME, laTME, and taTME. The quality of the studies was evaluated using the NOS and JADAD scales for retrospective cohort studies and randomized controlled trials, respectively. Direct meta-analysis and reticulated meta-analysis were performed using Review Manager software and R software, respectively. Results: Twenty-nine publications comprising 8,339 patients with rectal cancer were ultimately included. The direct meta-analysis indicated that the length of hospital stay was longer after RTME than after taTME, whereas according to the reticulated meta-analysis the length of hospital stay was shorter after taTME than after laTME (MD=-0.86, 95%CI: -1.70 to -0.096, P=0.036). Moreover, the incidence of anastomotic leak was lower after taTME than after RTME (OR=0.60, 95%CI: 0.39 to 0.91, P=0.018). The incidence of intestinal obstruction was also lower after taTME than after RTME (OR=0.55, 95%CI: 0.31 to 0.94, P=0.037). All of these differences were statistically significant (all P<0.05). There were no statistically significant differences between the three surgical procedures regarding the number of lymph nodes cleared, length of the inferior rectal margin, or rate of positive circumferential margins (all P>0.05). An inconsistency test using nodal analysis revealed no statistically significant differences between the results of direct and indirect comparisons of the six outcome indicators (all P>0.05). Furthermore, we detected no significant overall inconsistency between direct and indirect evidence. Conclusion: taTME has advantages over RTME and laTME, in terms of radical and surgical short-term outcomes in patients with rectal cancer.

Adverse reactions and precautions of teprotumumab in the treatment of thyroid-associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Thyroid-associated ophthalmopathy(TAO)is an autoimmune disease associated with thyroid dysfunction that can significantly impact quality of life, result in visual impairment and facial disfigurement. Traditional treatments are often unsatisfactory. Studies have shown that teprotumumab, a human monoclonal antibody that can inhibit insulin-like growth factor 1 receptor(IGF-1R), has become an emerging targeted drug for TAO. Although the drug has proven to be effective and relatively safe in the treatment of TAO, adverse reactions are worthy of attention of ophthalmologists with the continuous promotion of clinical application, including hearing impairment, hyperglycemia, diarrhea, muscle spasms, infusion reactions, cognitive decline, thyroid suppression, alopecia, nausea and fatigue. Teprotumumab was generally well tolerated, with most adverse events being mild or moderate in severity. This paper aims to review the adverse reactions and precautions of teprotumumab in the treatment of TAO.

Short-term clinical efficacy of radioactive125i seed implantation in treatment of pleural recurrence of thymoma / 第二军医大学学报

Objective To investigate the short-term clinical efficacy of radioactive125I seed implantation in the treatment of patients with thymoma recurrence. Methods Clinical data of patients with thymoma, who underwent radioactive125I seed implantation in Huadong Hospital of Fudan University during Sep. 2016 and Jun. 2017, were retrospectively collected. Inclusion criteria: local pleural recurrence lesions; intolerable to systemic chemotherapy or failure in previous chemotherapy; previously received high-dose chest radiotherapy; and normal coagulation function. All the patients were examined by computed tomography (CT), ultrasound and positron emission tomography-computed tomography (PET-CT) before operation. According to the Radiotherapy Planning System (TPS), the patients were inserted with the particle needles at the puncture point under the guidance of CT or ultrasound, and the distance between the sources was generally 0.5 cm. The clinical efficacy and adverse reactions were observed at 2 months after treatment. The patients were followed up for 3-9 months. Results A total of 13 patients underwent radioactive125I seed implantation, aged from 30 to 78 years, with 7 males and 6 females. The median number of implanted particles was 30, ranging from 20 to 58; the median dose of the particles was 1.9×107 Bq, and the range was (1.5-2.6)×107 Bq. The objective response rate was 100% (7 cases in complete remission and 6 in partial remission) after 2 months of follow-up, and all the 4 patients with chest wall pain were relieved. Pneumothorax occurred in 1 patient during particle implantation. During 3 to 9 months of follow-up, no patient developed disease progression at the site of particle implantation. Conclusion Radioactive125I seed implantation is a safe and effective method in the treatment of pleural recurrence of patients with thymoma, and can be used as a salvage therapy after the failure of traditional radiotherapy and chemotherapy, but its long-term effect needs further observation.

Study on determination and pharmacokinetics of metabolites from Folium Mori extract in rats / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To establish a RP-HPLC method for simultaneous determination of total quercetin, kaempferol and isorhamnetin in rat plasma after oral administration of Folium Mori extract (FME).</p><p><b>METHODS</b>After a single dose of FME (110 mg/kg) was taken, rat plasma samples were collected. The samples were hydrolyzed with hydrochloric acid (c=3.0 mol/L), the mixed solution was extracted with ether acetone mixture. The total quercetin, kaempferol and isorhamnetin in plasma samples were determined by HPLC, pharmacokinetic parameters were calculated by DAS 3.0 software.</p><p><b>RESULTS</b>The method was linear over the concentration ranges of 0.0545-8.70, 0.0954-14.7 and 0.0545-8.55 μg/ml for quercetin, kaempferol and isorhamnetin, respectively (r=0.9979, 0.9993, 0.9981). The absolute recoveries were 85.3%-86.1%, 79.4%-86.7% and 62.8%-89.7%, respectively and the assay recoveries were all from 94.7% to 107%. The relative standard deviation (RSD) of intra-and inter-day were less than 9.5% and 9.8%, respectively. The main pharmacokinetic parameters were as follows: T(1/2z) was 92.7, 67.9 and 54.2 h; Tmax was 0.400, 0.400 and 3.87 h; AUC(0-∞) was 68.0, 67.5 and 32.8 mg/h/L; MRT(0-∞) was 128, 85.2 and 72.0 h for quercetin, kaempferol and isorhamnetin, respectively.</p><p><b>CONCLUSION</b>The method established in this study is accurate, reliable and reproducible, and can be applied for determination of total quercetin, kaempferol and isorhamnetin in rat plasma after oral administration of FME; the pharmacokinetic studies showed that the distribution of drugs is rapid and elimination is very slow.</p>

Study on applying principle component analysis to data processing on chromatographic fingerprints for Pinellia Cum Bile / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the utility of principle component analysis (PCA) on chromatographic data for quality control to Dannanxing (Pinellia Cum Bile).</p><p><b>METHOD</b>Chromatographic fingerprints of sample were determined by TLC, PCA and multivariat analysis were used for data processing.</p><p><b>RESULT</b>The quantitative differences among samples procesed with different biles and heating time were found with the method.</p><p><b>CONCLUSION</b>PCA could be used in data processing for chromato-gramphic fingerprints of Dannanxing.</p>