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Objective To explore the clinical effect of Tongbi capsule combined with acupuncture for the patients with knee osteoarthritis and explore the mechanism of inflammatory response and hemorrheology. Methods According to the random table method, 88 KOA patients in our hospital from February 2016 to January 2017 were divided into the control group and the research group with 44 in each group. Patients in the control group were treated bycelecoxib capsule, while the patients in the research group were treated by Tongbi capsule combined with acupuncture. The treatment courses of two groups were two months. The clinical total effective rate of two groups of patients were compared after treatment. At the same time, the osteoarthritis index visual scale (WOMAC) and morning stiffness, joint tenderness index score were detected and compared after the treatment.The levels of serum tumor necrosis factor-α(TNF-α), interleukin (IL)-1β and IL-6 were detected by enzyme linked immunosorbent assay before and after the treatment. The hemorheology indexes were tested by automatic biochemical analyzer. In addition, the incidence of adverse reactions of two groups of patients was observed during treatment. Results The clinical total effective rate of the research group was 93.18％ (41/44), which was significantly higher than the control group72.73％ (32/44), and the difference was statistically significant (χ2=6.510, P=0.011). After treatment, the WOMAC (31.26 ± 6.12 vs. 36.17 ± 7.09, t=-3.477), joint tenderness index (1.75 ± 0.46 vs. 2.11 ± 0.54, t=-3.366) and morning stiffness score (1.62 ± 0.53 vs. 2.14 ± 0.51, t=-4.690) of the research group were significantly lower than those of the control group (P<0.05). The levels of TNF-α (7.36 ± 1.45 pg/ml vs. 8.02 ± 1.54 pg/ml, t=-2.070), IL-1β (27.82 ± 5.22 μg/ml vs. 33.05 ± 5.17 μg/ml, t=-4.722), IL-6 (2.81 ± 0.58 ng/ml vs. 3.34 ± 0.53 ng/ml, t=-4.475) of the research group were significantly lower than those of the control group (P<0.05). The whole blood high shear viscosity (12.09 ± 3.46 mPa?s vs. 14.22 ± 3.51 mPa?s, t=-2.867), whole blood low shear viscosity (2.53 ± 0.68 mPa?s vs. 3.32 ± 0.71 mPa?s, t=-5.330), whole blood viscosity (1.35 ± 0.29 mPa?s vs. 1.60 ± 0.41 mPa?s, t=-3.302), erythrocyte sedimentation rate (7.10 ± 2.06 mm/h vs. 8.02 ± 2.13 mm/h, t=-2.059), fibrinogen (2.71 ± 0.53 g/L vs. 3.42 ± 0.65 g/L, t=-5.615) and erythrocyte deformation index (0.57 ± 0.16 vs. 0.71 ± 0.19, t=-3.739) of the research group were significantly lower than those of the control group (P<0.05). The incidence of adverse reactions of control group was 11.37％ (5/44), while the incidence of adverse reactions of resarch group was 6.82％ (3/44), which the difference of the incidence of adverse reactions between two groups showed no statistical significance (χ2=0.550, P=0.458). Conclusions The Tongbi capsule combined with acupuncture can reduce the degree of inflammation, and also improve hemorheology indexes of KOA patients.
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Objective To analyze the clinical efficacy of preoperative concurrent radiotherapy and chemo-therapy and radical operation in the treatment of cervical cancer patients with locally advanced cervical cancer (IB -IIB).Methods 80 patients who were diagnosed locally advanced (stage IB -IIB)cervical cancer,were divided into observation group (preoperative radiotherapy and chemotherapy group)and control group (radical radio-therapy group).The short -term efficacy,complications and follow -up data were compared between the two groups. Results The short -term efficacy of the observation group was 87.2%,which of the control group was 95.1%,and there was no significant difference (χ2 =1.579,P =0.209).As to the early complications of the two groups,there were no significant differences in gastrointestinal tract reaction(χ2 =0.000,P =0.987),rectal reaction(χ2 =2.709, P =0.100),bladder reaction (χ2 =1.343,P =0.247)and bone marrow suppression(χ2 =1.898,P =0.168).Late complications:in the observation group,the radiation proctitis[4 cases(10.3%)vs.14 cases(34.1%)]and the radiation cystitis[3 cases(7.7%)vs.13 cases(31.7%)]were less than those of the control group,the differences were statistically significant(χ2 =6.542,P =0.011&χ2 =7.205,P =0.007).The average follow -up time was 38.6 months in the observation group,which was 44.8 months in the control group.There was no significant difference in survival rate between the two groups(χ2 =0.075,P =0.784 & χ2 =0.032,P =0.858).Conclusion Locally advanced cervical cancer (IB -IIB)patients received preoperative concurrent radiotherapy and chemotherapy has important clinical value.The treatment makes the local giant block tumor shrink significantly,which is conducive to the implementation of surgery,and reduce the incidence of late complications compared with radical radiotherapy.
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Objective To evaluate the efficacy of double filtration plasmapheresis (DFPP) combined with immunosuppressive agents (leflunomide plus methotrexate) on synovitis in magnetic resonance imaging (MRI) in patients with high active rheumatoid arthritis (RA). Methods Fifty eight patients with RA (disease duration 6 months to 12 years) were randomly divided. Thirty-one were randomized to the treatment group and 27 were randomized to the control group. All patients received leflunomide 10 mg, two times daily; plus methotrexate 15 mg orally once weekly. DFPP was performed in the treatment group once 1-2 weeks for 3-4 sessions. Control patients did not receive DFPP. All patients underwent contrast-enhanced MRI of the right wrist at the baseline and 6 months, 1 month in the treatment group. The signs including synovitis pannus, bone marrow edema and effusion were observed on MRI. The scoring of synovial hypertrophy, pannus, bone marrow edema were measured according to the outcome measures in RA MRI scoring system. Comparisons between groups were performed with paired-samples t test and independent-sample t test. Results The MRI synovitis score, MRI pannus score and MRI bone marrow edema in the treatment group was (1.4±1.6), (0.13± 0.35) and (5±4) respectively,so was significantly lower than that of the control group [respectively for (7.9± 1.3), (2.76±0.43), (16±12),P<0.01]. 53% of the treatment group satisfied both the disease activity score 28-joint assessment and MRI synovitis assessment (no enhancement of synovium or pannus, no effusion), but none in the control group (P<0.01). Significant changes at 1 month was observed in DAS28 and HAQ scores (P<0.01), but not in the MRI synovitis score, MRI pannus score, MRI bone marrow edema score and effusion in the treatment group (P>0.05). Conclusion DFPP combined with immunosuppressive agents can significantly improve synovitis in MRI in patients with high active RA. Improvement of the signs of MRI is later than that in the clinic. So imaging assessment may be necessary for accurate evaluation of disease status and selection of therapy.
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Objective To evaluate the efficacy of double filtration plasmapheresis (DFPP) in the treatment of patients with refractory rheumatoid arthritis (RA). Methods Eighty-two patients were randomly aesigned,42 to the DFPP group and 40 to the no-DFPP group. All patients previously experienced an incomplete response to 2-3 dis-ease-modifying antirheumatic drugs (DMARDs) and 1-2 nonsteroidal anti-inflammatory drugs (NSAIDs) or predni-sene. All patients received sulphasalazine (SASP,0.75 g three times daily) plus methotrexate (MTX, 10 mg orally once weekly). DFPP was performed once a week for 2-3 sessions. A total of 121 plasmapheresis procedures were per-formed in 42 patients. Control patients did not receive sham DFPP. The efficacy measures recorded one day after the final treatment and latest month in follow up for 12～24 months included the American College of Rheumatology 20% ,50% ,and 70% improvement criteria (ACR20, ACR50, and ACR70), the Health Assessment Questionnaire estimate of disability (HAQ); and the disease activity index. Results Patients in the DFPP group had ACR 20, ACR 50 and ACR 70 improvements of 100% ,92.9% and 81.0%,as compared with the patients in no-DFPP group 17.5% ,0,and 0 (P<0.001). Significant change from baseline was observed in HAQ scores in the DFPP group but not in the no-DFPP group (P<0.001). The changes from baseline in the disease activity scores were significantlygreater than in the no-DFPP group (P<0.001). Conclusion DFPP therapy significantly alters the signs and symp-toms of refractory RA. There are significant increases in physical function and improvement in quality of life.
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Purpose To study the effect of overexpressing either wild type or a familial Alzheimer disease mutant presenilin 1 (mPS1) on tau phosphorylation in neuroblastoma NG-108 cells. Methods Three different plasmids transfected NG-108 cells respectively. Immunostaining and confocal microscopic technique were used to study the distribution of presenilin 1 and phosphorylated tau. Immunoblot test was applied to investigate the change of tau phosphorylation. Results Immunostaining showed that in brain of sporadic Alzheimer disease, PS1 mainly distributed in neuron and partially colocalized with the phosphorylated tau. Immunoblot tests showed that the cells transected either wild type PS1 or mPS1 contained more phorphorylated tau than the control cells. However, MTT test showed no significant difference between mock transfected cells and the wPS1 or mPS1 transfected cells. In addition, after transfection of the constructed PS1-EGFP vector, overexpressed EGFP-PS1 was located at cell surface membrane and subcellular organelles at earlier time at 12 hr, then EGFP-PS1 diffused in cytosol. Immunocytochemical observations demonstrated that some of the PS1-EGFP transfected cells contained more phosphorylated tau protein, which formed aggresome with PS-1-EGFP. When treated with phosphotase inhibitor okadaic acid, in the PS1-EGFP transfected cells accumulated more phosphorylated tau than the un-transfected cells. Conclusions Wild type PS1 is possibly involved in tauopathy in sporadic Alzheimer's disease.
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Free radicals are extensively existed in aerobic organisms with high reactivity. In cerebral ischemia, free radicals can be generated in excess of cellular antioxidant capacity resulting in severe damage. Hydroxyl radical is one of the most potent and reactive species. It plays a key role in neuronal damage induced by ischemia and reperfu-sion. This review will focus on: possible routes forthe formation of hydroxyl radical during cerebral ischemia; changes of hydroxyl radical contents induced by ischemia; the effect of hydroxyl radical on ischemic neuronal damage; the protective effects of hydroxyl radical scavengers on neuronal damage induced by ischemia.