ABSTRACT
Hepatocellular carcinoma (HCC) has been known as the second common leading cancer worldwide, as it responds poorly to both chemotherapy and medication. Triptolide (TP), a diterpenoid triepoxide, is a promising treatment agent for its effective anticancer effect on multiple cancers including HCC. However, its clinical application has been limited owing to its severe systemic toxicities, low solubility, and fast elimination in the body. Therefore, to overcome the above obstacles, photo-activatable liposomes (LP) integrated with both photosensitizer Ce6 and chemotherapeutic drug TP (TP/Ce6-LP) was designed in the pursuit of controlled drug release and synergetic photodynamic therapy in HCC therapy. The TP encapsulated in liposomes accumulated to the tumor site due to the enhanced permeability and retention (EPR) effect. Under laser irradiation, the photosensitizer Ce6 generated reactive oxygen species (ROS) and further oxidized the unsaturated phospholipids. In this way, the liposomes were destroyed to release TP. TP/Ce6-LP with NIR laser irradiation (TP/Ce6-LP+L) showed the best anti-tumor effect both
ABSTRACT
Objective: To compare the effectiveness of exercise therapy with surgery for lumbar spinal stenosis
Methods: Five English databases PubMed, the Cochrane Library, Web of science, OVID and PEDro database were searched for randomized controlled trials comparing surgical procedures with exercise therapy for lumbar spinal stenosis. Information on patients, study design, inclusion criteria, intervention and followup, outcomes, treatment details and adverse events were extracted. Meta-analysis was performed using Review Manager Version 5.3
Results: Two randomized controlled trials and one mixed design trial with a total of 897 patients were included. The pooled results showed a significant difference between exercise and surgery in Oswestry Disability Index at two years [MD= 3.85, 95%CI: 0.48 to 7.22; P=0.03], but no significant difference at six months [MD= 2.18, 95%CI: -2.80 to 7.17; P=0.39] and one year [MD= 4.26, 95%CI: -1.79 to 10.32; P=0.17]. In terms of physical function of 36 Items Short Form Health Survey, there were no significant differences between exercise and surgery at six months [MD= -2.23, 95% CI: -7.46 to 2.99; P=0.40], one year [MD= -2.17, 95% CI: -7.44 to 3.10; P=0.42] and two years [MD= -0.67, 95% CI: -6.16 to 4.82; P=0.81]
Conclusion: In brief, the current evidence demonstrated a trend that exercise therapy had a similar effect for lumbar spinal stenosis compared with decompressive laminectomies. However, for the small sample size and low methodology quality of the included trials, some rigorously designed and large-scaled RCTs need to be performed to confirm the conclusion
ABSTRACT
Objective: To evaluate the efficacy of core stability exercise versus conventional exercise in the treatment of lumbar spinal stenosis
Methods: Between January 2014 and May 2017, patients with lumbar spinal stenosis were recruited and divided into group of core stability exercise or conventional exercise randomly. All the patients were treated using middle frequency electrotherapy, in addition to that, the patients in group of core stability exercise were treated using core stability exercise. The patients in group of conventional exercise were treated using conventional exercise. The outcome was evaluated using Japanese Orthopedic Association [JOA] score, self-reported walking capacity and lumbar lordosis angle at baseline and after treatment
Results: In the current study, sixty-two patients with lumbar spinal stenosis met the inclusion and exclusion criteria, in which 33 patients were included in group of core stability exercise and 29 in group of conventional exercise. After treatment, both Japanese Orthopedic Association scores [p<0.05] and self-reported walking capacity [p<0.05] increased significantly in each group when compared with baseline. The self-reported walking capacity and JOA scores in the group of core stability exercise were significantly higher than those in the conventional exercise group [p<0.05]. However, both the intragroup and intergroup comparison of lumbar lordosis presented with no significance [p>0.05]
Conclusion: Core stability exercise presents with better efficacy than conventional exercise in the treatment of lumbar spinal stenosis.