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OBJECTIVE@#To compare the clinical efficacy between staged acupuncture based on "thoroughfare vessel is the sea of blood" theory combined with routine hormone replacement cycle treatment and routine hormone replacement cycle treatment for patients with recurrent implantation failure (RIF) of thin endometrium.@*METHODS@#A total of 72 RIF patients with thin endometrium were randomly divided into an observation group and a control group, 36 cases in each group. The patients in the control group were treated with routine hormone replacement cycle treatment. Based on the treatment of the control group, the patients in the observation group were treated with staged acupuncture based on "thoroughfare vessel is the sea of blood" theory. The main acupoints were Neiguan (PC 6) and Gongsun (SP 4), and the supplementary acupoints were selected according to the menstrual cycle and syndrome differentiation; the acupuncture was given once every other day, 3 times a week, for 3 consecutive menstrual cycles. The thickness and shape of endometrium, and Hamilton anxiety scale (HAMA) score were observed at implantation window before and after treatment; the clinical pregnancy rate, live birth rate and cycle cancellation rate were compared between the two groups; the correlation between endometrial thickness and HAMA score was analyzed.@*RESULTS@#Compared before treatment, the endometrial thickness in the two groups and the proportion of type A+B endometrium in the observation group were increased (P<0.05), and the HAMA scores in the two groups were decreased (P<0.05) after treatment. The above indexes in the observation group were superior to those in the control group (P<0.05). The clinical pregnancy rate and live birth rate in the observation group were higher than those in the control group (P<0.05), and the cycle cancellation rate was lower than that in the control group (P<0.05). There was a negative correlation between endometrial thickness and HAMA score (P<0.05).@*CONCLUSION@#Based on the routine hormone replacement cycle treatment, the addition use of staged acupuncture based on "thoroughfare vessel is the sea of blood" theory could improve the thickness and shape of endometrium, relieve anxiety, increase the clinical pregnancy rate and live birth rate, and reduce the cycle cancellation rate in RIF patients with thin endometrium. The curative effect is superior to the routine hormone replacement cycle treatment alone.
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Female , Pregnancy , Humans , Anxiety , Anxiety Disorders , Acupuncture Therapy , Endometrium , HormonesABSTRACT
Objective:To investigate the expression of Mucosal-associated invariant T (MAIT) cells in the peripheral blood of ankylosing spondylitis (AS) patients, and to analyze its clinical significance.Methods:Sixty-four AS patients from September 2020 to September 2022 in Fujian Provincial Hospital and 60 healthy controls were enrolled. The expression of MAIT cells and CD69 +MAIT cells were detected by immunofluorescence. Spondylarthritis research consortium of Canada (SPARCC) scores of sacroiliac joint magnetic resonance imaging (MRI) were calculated and were analyzed based on clinical data. The changes of MAIT cells were observed in 7 patients with AS after treatment. t test, variance analysis and Pearson correlation analysis were used for statistical analysis. Results:The expression of MAIT cells in the peripheral of AS patients was significantly lower than that in the controls [(2.81±0.27)% and (4.46±0.86)% respectively, t=2.33, P=0.022], while CD69 +MAIT cells were significantly higher [(12.0±1.0)% and (7.8±1.2)% respectively, t=2.31, P=0.024]. The level of CD69 +MAIT cells were significantly positively correlated with erythrocyte sedimentation rate (ESR) ( r=0.39, P=0.010), C-reactive protein (CRP) ( r=0.36, P=0.012), ASDAS ( r=0.35, P=0.013) and SPARCC scores ( r=0.38, P=0.006) of AS patients. ASDAS scores and CD69 +MAIT cells obviously decreased in 7 treated AS patients ( F=7.62, P=0.007 and F=4.97, P=0.027 respectively). Conclusion:The expression of peripheral MAIT cells in AS patients is lower than that in healthy controls, but the number of the activated MAIT cells is increased. Levels of activated MAIT cells may in some extent reflect the inflammatory state and disease activity of AS, as well as inflammatory destruction of sacroiliac joint, and therapeutic effect. MAIT cells may partially participate in the inflammatory response and play a role in the pathogenesis of AS.
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ObjectiveTo investigate the immunomodulatory mechanism of Kangxian Yixin prescription （KYP） on autoimmune injury mice and its relationship with the T helper 17 （Th17）/regulatory T cell （Treg） balance. MethodSixty healthy 8-week-old male BALBc mice were randomly divided into a normal group and an experimental group at a ratio of 1∶5. On the 0th， 7th， and 28th days， 0.2 mL of porcine cardiac myosin emulsion （containing 0.1 mg of porcine cardiac myosin） was subcutaneously injected into the groin， armpit， and back of the mice in the experimental group to induce an animal model of myocardial immune injury. Mice with myocardial immune injury were randomly divided into a model group （Model）， a KYP group （20.4 g·kg-1·d-1， ig）， and a valsartan group （12 mg·kg-1·d-1， ig）. Mice in the control group and the model group received the same amount of normal saline by gavage. After four weeks of intervention， the heart tissues were collected. Hematoxylin-eosin （HE） staining and Masson staining were used to detect pathological damage in heart tissues. Enzyme-linked immunosorbent assay （ELISA） was used to detect the expression of type B-type natriuretic peptide （BNP）， anti-cardiac antibody， interleukin-17 （IL-17）， and interleukin-10 （IL-10） in the serum of mice， and the expression levels of Th17 cells and Tregs in the spleen were detected by flow cytometry. The protein expression of B-cell lymphoma-2 （Bcl-2） and Bcl-2-associated X （Bax） in heart tissues was detected by Western blot， and the mRNA expression of retinoid-related orphan receptor gamma t （RORγt） and forkhead box P3 （FoxP3） in the spleen was detected by quantitative real-time polymerase chain reaction （Real-time PCR）. ResultCompared with the control group， the model group showed worsened pathological damage in heart tissues， elevated serum levels of BNP， anti-myocardial antibody， and IL-17， decreased serum expression of IL-10 （P<0.05）， increased expression of Th17 cells and reduced expression of Tregs in spleen tissues （P<0.05）， increased protein expression of Bax， diminished Bcl-2 protein expression， elevated Bax/Bcl-2 ratio， up-regulated mRNA expression of RORγt， dwindled mRNA expression of FoxP3， and elevated ratio of RORγt/FoxP3 （P<0.05）. Compared with the model group， the KYP group and the valsartan group displayed relieved pathological damage in heart tissues， decreased serum expression of BNP， anti-myocardial antibody， and IL-17， increased serum expression of IL-10 （P<0.05）， reduced expression of Th17 cells and increased Tregs in spleen tissues （P<0.05）， dwindled protein expression of Bax and elevated protein expression of Bcl-2 in heart tissues （P<0.05）， diminished Bax/Bcl-2 ratio， reduced mRNA expression of RORγt， up-regulated FoxP3， and down-regulated ratio of RORγt/FoxP3 （P<0.05）. ConclusionKYP may improve myocardial immune damage by regulating the Th17/Treg cell balance.
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To evaluate the economy and applicability of Jinye Baidu Granules in the treatment of acute upper respiratory tract infection, a randomized, double-blind, positive drug parallel control clinical trial was conducted in this study. Stratified block random, double-blind and double simulation test was used. The experimental group took Jinye Baidu Granules, 10 g/time, three times a day, and Compound Shuanghua Granules placebo, 6 g/time, four times a day. The control group took Compound Shuanghua Granules, 6 g/time, 4 times a day, and Jinye Baidu Granules placebo, 10 g/time, 3 times a day. The course of treatment was 5 days. The total cost of this study included direct medical cost and indirect medical cost. The incremental cost-effect analysis method was used for evaluation. Treeage Pro software was used to build a pharmaco-economics model and make statistical analysis. Patients from 10 hospitals were divided into experimental group(304 cases) and control group(302 cases). The baseline values of age, sex ratio, clinical symptoms and signs scores, and important physical examination indexes of the two groups were compared. After 5 days of treatment, the cost per capita of the experimental group was(388.06±94.17) Yuan, and that of the control group was(378.47±95.46) Yuan. The cost of direct medical treatment per capita was(271.24±54.11) Yuan for the experimental group and(264.88±112.71) Yuan for the control group. The average cost of indirect medical treatment was(116.82±82.75) Yuan in the experimental group and(113.59±87.77) Yuan in the control group, with no significant difference in the cost of medical treatment per capita, the cost of direct medical treatment per capita and the cost of indirect medical treatment per capita between both groups. The results of incremental cost-effect analysis based on the total score difference in symptoms and signs after 5 days of treatment showed that ICER=23.39 Yuan/score, which was less than the willingness to pay 100 Yuan/score determined through expert interviews. The experimental group had economic advantages over the experimental group, with the economic probability of 53%. Sensitivity analysis supported the robustness of the results. The results of incremental cost-effect analysis based on the total recovery rate of symptoms and signs showed that compared with the experimental group, the control group had lower cost, better effect and absolute economic advantage, with a corresponding probability of 55%. Based on the above results, it is concluded that there is no significant difference in economic outcome between Jinye Baidu Gra-nules and Compound Shuanghua Granules in the treatment of acute upper respiratory tract infection.
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Humans , Cost-Benefit Analysis , Double-Blind Method , Marketing , Respiratory Tract InfectionsABSTRACT
Pathological scar is a kind of skin fibrotic disease caused by abnormal wound healing, including hypertrophic scar and keloid. Pathological scar may lead to aesthetic flaws, limb dysfunction and local discomfort in patients. Due to the complexity of the wound healing process, the formation of scar is affected by many factors. In addition to traditional surgical, laser, cryostatic and hormone injection methods for the treatment of pathological scar, there are new therapies, such as mesenchymal stem cell therapy, fat transplantation, interferon, and botulinum toxin. They are widely used in clinical practice, but with such problems as high prices and many side effect. Traditional Chinese medicine (TCM) has a long history in treating pathological scar. In recent years, in vivo and in vitro studies have shown that TCM has effect IN reducing inflammation, inhibiting fibroblast proliferation, regulating fibroblast activation and migration, inducing fibroblast apoptosis and autophagy, promoting the degradation of extracellular matrix (ECM) and reducing angiogenesis in general. Besides, TCM has also a certain regulatory role in the signaling pathways, such as transforming growth factor-β1 (TGF-β1)/Smads, phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) and sonic hedgehog (Shh). There are still some contradictions in relevant studies, and specific mechanisms remain to be further improved. This paper summarizes the study content, findings and relevant mechanisms of different TCM based on in vivo and in vitro experiments, analyzes the advantages and disadvantages of TCM in the prevention and treatment of pathological scar, and its prospects in clinical application, so as to provide basis and ideas for future scar studies.
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OBJECTIVE: To investigate the effect of pure total flavonoids from Citrus(PTFC) on the NLRP3 inflammasome pathway in mice with high-fat/high-fructose diet induced non-alcoholic steatohepatitis(NASH), and discuss its anti-NASH mechanism. METHODS: Fifty C57BL/6 mice were randomly divided into normal group, model group, PTFC low-dosage group, medium-dosage group and high-dosage group, 10 in each group. A high-fat/high-fructose diet was given for 16 weeks to establish the NASH models, and the PTFC groups were administrated with PTFC at the dosage of 25, 50, 100 mg•kg-1•d-1 from the 5th week, respectively. Histopathologic changes of the liver tissue were observed by HE and oil red O staining; serum CHOL, TG, ALT, AST were detected by biochemical method; the levels of NLRP3, ASC, Casp1 and IL-1β mRNA in the liver tissue were determined by Realtime-PCR; the protein expression of NLRP3 and Casp1 was detected by Western blot. RESULTS: Sixteen weeks administration of high-fat/high-fructose diet induced significantly higher weight, increased NAFLD activity score (NAS) of the liver tissue, higher level of serum CHOL, ALT and AST, lower level of serum TG, increased expression of NLRP3, ASC, Casp1 and IL-1β mRNA in liver, and increased protein expression of Casp1. After PTFC administration, the mice, especially the PTFC high dosage group, exhibited (compared with the model group) marked lower NAS, decreased serum ALT and AST level, increased TG level, impaired NLRP3, ASC, Casp1 and IL-1β mRNA expression, and decreased protein expression of NLRP3 and Casp1. CONCLUSION: The NLRP3 inflammasome pathway may play a key role in the development and progress of NASH in mice, and PTFC prevents the development of NASH through suppressing this pathway.
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Background@#Accumulating documents have demonstrated that long noncoding RNAs (lncRNAs) play critical roles in tumorigenesis. As an lncRNA, nuclear-enriched abundant transcript 1 (NEAT1) has been identified to be involved in the progression of many types of cancers. However, the biological function of NEAT1 in cervical cancer is not fully investigated. The aim of this study was to disclose the specific biological function of lncRNA NEAT1 in cervical cancer progression.@*Methods@#Quantitative real-time polymerase chain reaction (qRT-PCR) was utilized to identify the expression of lncRNA NEAT1 in the cervical cancer tissues and cell lines. All cervical cancer samples used in this study were collected from the Affiliated Suzhou Hospital of Nanjing Medical University between September 2012 and September 2017. The correlation between NEAT1 expression and the overall survival rate of cervical cancer patients was analyzed by Kaplan-Meier analysis. The effects of NEAT1 knockdown or overexpression on cell proliferation were tested by performing MTT assays and colony formation assays. Transwell assays were conducted to detect the migratory ability of cervical cancer cells, in which NEAT1 was silenced or overexpressed. Western blotting was utilized to validate whether NEAT1 promotes cervical cancer progression through activating PI3K-Akt signaling pathway.@*Results@#High expression of NEAT1 predicted poor prognosis of cervical cancer patients (χ = 0.735, P = 0.005). Knockdown of NEAT1 decreased the number of colonies in CaSki cell from 136.667 ± 13.503 to 71.667 ± 7.506 (t = -18.76, P = 0.003) and decreased the number of colonies in HeLa cell from 128.667 ± 13.317 to 65.667 ± 7.024 (t = -5.54, P = 0.031). However, overexpression of NEAT1 increased the number of colonies in SiHa cell from 84.667 ± 12.014 to 150.667 ± 18.037 (t = 7.27, P = 0.018). Knockdown of NEAT1 decreased the migratory number of CaSki cell from 100.333 ± 9.866 to 58.333 ± 5.859 (t = -8.08, P = 0.015) and reduced the migratory number in HeLa cell from 123.667 ± 12.097 to 67.667 ± 7.095 (t = -6.03, P = 0.026). Overexpression of NEAT1 increased the migratory number of SiHa cell from 127.333 ± 16.042 to 231.333 ± 31.786 (t = 4.92, P = 0.039).@*Conclusion@#NEAT1 may exert oncogenic function in cervical cancer and serve as a novel therapeutic target for cervical cancer.
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Female , Humans , Middle Aged , Cell Line, Tumor , Cell Proliferation , HeLa Cells , Phosphatidylinositol 3-Kinases , Physiology , RNA, Long Noncoding , Physiology , Uterine Cervical Neoplasms , GeneticsABSTRACT
Objective: This study was conducted to determine the proper percentage of EN in the total energy and nutrition support for critically ill patients with traumatic brain injury (TBIs). Methods: 94 cases were randomly divided into 3 groups according to the percentage of EN in the total energy: 100％ EN group in which patients received 100％ calories from EN; 75％ EN group in which patients received 75％ calories from EN, 25％ from PN; 50％ EN group in which patients received 50％ calories fromm EN, 50％ from PN. At baseline and follow-up on day 4, 7, 10, nutrition parameters, complete blood count and electrolytes as well as metabolic parameters including tests of liver and renal function were measured. Complications during treatment were recorded and the prognosis was finally judged. Results: Total protein and albumin were significantly higher in the 50％ EN and 75％ EN group on day 7 than in TEN group (P＜ 0. 05). There was significance difference found in complications between 75％EN and 50％EN group. A reduction in the length of stay in the hospital and expenses in the ICU for 10 days in the 75％ EN group (P ＜ 0. 05) was also observed. Conclusion: 75％ calories from EN in the total energy and nutrition support appeared to have great impact on management of critically ill patients with traumatic brain injury.
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This article briefly described the existing problems in talent training of TCM informatics, conducted discussion according to discipline personnel training practice teaching mode, proposed to introduce Arduino open-source hardware into TCM informatics teaching, try to carry out practice exploration for existing classroom and experiment teaching, and proposed relevant suggestions to promote learning interest of students and improve their application ability, with a purpose to further improve the practice teaching mode of TCM informatics, cultivate "TCM+informatics" compound and application talents to promote long-term development of this discipline.
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Objective@#To investigate the safety and effectiveness of radical retropubic prostatectomy (RRP) with adjuvant androgen deprivation or external radiotherapy in the treatment of prostate cancer (PCa) with pelvic lymph node metastasis (PLNM).@*METHODS@#Twenty PCa patients underwent bilateral pedal lymphangiography (PLG) preoperatively, and 11 of them received lymph node aspiration for examination of the mRNA expressions of prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) in the lymph fluid by real-time RT-PCR. All the patients were treated by RRP with extended dissection of pelvic lymph nodes, and 3 of them by external radiotherapy in addition after recovery from urinary incontinence because of positive surgical margins, followed by adjuvant androgen deprivation therapy.@*RESULTS@#Real-time RT-PCR showed positive mRNA expressions of PSA and PSMA in the lymph fluid of the 11 patients, all pathologically confirmed with PLNM. The median intraoperative blood loss was 575 ml, with blood transfusion for 5 cases. Positive surgical margin was found in 3 cases, lymphorrhagia in 2 and urinary leakage in another 2 each. There were no such severe complications as vascular injury and rectum perforation. The patients were followed up for 6－48 (mean 42) months, during which, biochemical recurrence was observed in 12 cases at a median of 12 months postoperatively and 2 patients died at 12 and 48 months respectively.@*CONCLUSIONS@#Bilateral PLG and lymph node aspiration for examination of the mRNA expressions of PSA and PSMA in the lymph fluid help to confirm PLNM preoperatively. Radical retropubic prostatectomy with adjuvant androgen deprivation or external radiotherapy is safe and effective for the treatment of PCa with PLNM, but it should be chosen cautiously for those with Gleason 5+5.
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Humans , Male , Androgen Antagonists , Therapeutic Uses , Antigens, Surface , Metabolism , Chemotherapy, Adjuvant , Glutamate Carboxypeptidase II , Metabolism , Lymph Node Excision , Lymph Nodes , Pathology , Lymphatic Metastasis , Pelvis , Postoperative Period , Prostate-Specific Antigen , Metabolism , Prostatectomy , Methods , Prostatic Neoplasms , Drug Therapy , Metabolism , General SurgeryABSTRACT
Objective To discuss the application of enhanced CT subtraction technique in evaluating residual hepatocelluar carcinoma activity after transcatheter arterial chemoembolization (TACE).Methods A total of consecutive 22 patients with clinically-confirmed hepatocellular carcinoma (HCC),who received TACE,were retrospectively collected.Multi-phase enhanced CT examination of liver was performed in all patients after the initial TACE,and the presence or absence of residual active tumor was determined at the second time of TACE.The enhanced arterial phase CT images were used to subtract the corresponding plain scan images,and the subtraction images were thus obtained.The post-subtraction CT values of the lesions that showed iodine oil deposit were measured,which were compared with angiography findings performed at the second time of TACE.The residual tumor activity indicated by post-subtraction images was statistically analyzed.Results In 22 HCC patients receiving TACE,a total of 37 lesions showed iodine oil deposit after the initial TACE.Assessment of tumor activity indicated that 34 lesions had tumor activity and 3 lesions had no tumor activity.The mean post-subtraction CT value of the lesions in the tumor activity group was (79±68) HU,while it was (1 ±1) HU in the tumor non-activity group;the difference between the two groups was statistically significant (P=0.007).Analysis with receiver operating characteristic (ROC) curve indicated that when the post-subtraction CT value of the lesion was greater than one HU,the sensitivity and specificity for diagnosing residual tumor were 97.06％ and 100％ respectively,and the area under the ROC curve was up to 0.975.Conclusion The subtraction images obtained by subtracting the enhanced arterial phase CT images from the plain scan images can accurately and intuitively determine the presence or absence of residual active HCC lesions after TACE.
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Objective To systematically evaluate the effectiveness and safety of Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms. Methods Articles of clinical randomized controlled trials about Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms from the establishment of the databases to October of 2016 from CNKI, CBM, Chongqing Weipu, Wanfang database, Cochrane Library, PubMed and Embase were retrieved by computers. Bias risk assessment tools in Cochrane systematic evaluation handbook 5.1.0 was used to conduct quality evaluation for included articles. RevMan5.3 software was used to carry out Meta-analysis. Results Totally 12 articles and 839 patients were included. Results of Meta-analysis showed that Elemene combined with radiotherapy had more obvious curative effect on narrowing the neoplasm compared with pure radiotherapy [OR=2.73, 95%CI (1.97, 3.77), P<0.000 01], and improve patients' life quality at the same time [OR=3.85, 95%CI (2.23, 6.65), P<0.000 01], and relieve adverse reactions [OR=4.16, 95%CI (2.40, 7.22), P<0.000 01]. Conclusion Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms shows confirmed efficacy, and is relatively safe. But whether the program should be widely used in clinic, more large sample, multi-center, and high-quality clinical randomized controlled trials are still needed.
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Digital construction and network service are the inevitable trend of the development of TCM literature modernization, and the model based on App Store has become the trend of electronic publications. This article analyzed the current status and existing main problems of the platform of TCM literature electronic publication. In view of the above problems, combined with the development of TCM literature electronic publication, this article proposed a transformation platform based on App Store, and further elaborated the function, design and technology of the platform.
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OBJECTIVE:To evaluate therapeutic efficacy and safety of Aidi injection combined with S-1 for advanced gastric cancer systematically,and to provide evidence-based reference. METHODS:Retrieved from CJFD,Wanfang database,VIP, CBM,Cochrane Library,PubMed and EMBase,randomized controlled trials(RCTs)about Aidi injection combined with S-1(tri-al group) vs. S-1 alone (control group) for advanced gastric cancer were collected. Meta-analysis was conducted by Rev Man 5.3 software after data extraction and quality evaluation by risk bias evaluation tool of Cochrane Handbook Version 5.1.0. RESULTS:A total of 8 RCT were included,involving 690 patients. Results of Meta-analysis showed that there was no statistical significance in therapeutic efficacy of solid tumor between 2 groups [OR=1.19,95%CI(0.88,1.61),P=0.26]. The improvement rate of survival quality[OR=3.62,95%CI(2.48,5.30),P<0.001],immunoglobulin level [CD3:SMD=1.31,95%CI(1.06,1.56),P<0.001;CD4:SMD=1.71,95%CI(1.38,2.04),P<0.001;CD8:SMD=-1.46,95%CI(-1.68,-1.23),P<0.001;CD4/CD8:SMD=1.45,95%CI(1.14,1.76),P<0.001] in trial group was significantly higher than control group. The incidence of leukopenia [RR=0.52,95%CI (0.40,0.68),P<0.001],thrombocytopenia [RR=0.49,95%CI(0.36,0.67),P<0.001] and gastrointestinal disorder [RR=0.56,95%CI(0.43,0.71),P<0.001] in trial group were significantly lower than control group,with statistical significance. CONCLUSIONS:Compared to S-1 alone,S-1 combined with Aidi injection can not significantly improve therapeutic efficacy of solid tumor therapy, but can improve survival quality and immunity of patients,as well as reduce the occurrence of ADR.
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Objective To systematically evaluate the effectiveness and safety of Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms. Methods Articles of clinical randomized controlled trials about Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms from the establishment of the databases to October of 2016 from CNKI, CBM, Chongqing Weipu, Wanfang database, Cochrane Library, PubMed and Embase were retrieved by computers. Bias risk assessment tools in Cochrane systematic evaluation handbook 5.1.0 was used to conduct quality evaluation for included articles. RevMan5.3 software was used to carry out Meta-analysis. Results Totally 12 articles and 839 patients were included. Results of Meta-analysis showed that Elemene combined with radiotherapy had more obvious curative effect on narrowing the neoplasm compared with pure radiotherapy [OR=2.73, 95%CI (1.97, 3.77), P<0.000 01], and improve patients' life quality at the same time [OR=3.85, 95%CI (2.23, 6.65), P<0.000 01], and relieve adverse reactions [OR=4.16, 95%CI (2.40, 7.22), P<0.000 01]. Conclusion Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms shows confirmed efficacy, and is relatively safe. But whether the program should be widely used in clinic, more large sample, multi-center, and high-quality clinical randomized controlled trials are still needed.
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[Abstact] Purpose To investigate the value of apparent diffusion coefficient (ADC) of diffusion weighted imaging (DW1) in the evaluation of the efficacy of treatment of nonsmall cell lung cancer (NSCLC) with tyrosine kinase inhibitor (TKI).Materials and Methods Nineteen patients with advanced NSCLC who treated with TKIs from May 2014 to December 2015 were recruited prospectively.All patients underwent CT and MRI scans three times before targeted therapy,after 1 week and 4 weeks of treatment.The tumor maximal diameter and mean ADC value at different time points were compared.The correlations between mean ADC value and tumor maximal diameter and maximum diameter change rate at different time points were analyzed.Bland-Altman analysis was performed to confirm the reproducibility of measurements.Results The ADC value after 1 week of treatment was significantly increased compared with that before treatment (t=-6.329,P＜0.05),but the change of tumor maximal diameter was not significant (P＞0.05).The ADC value was significantly increased after 4 weeks of treatment compared with that before treatment (t=-4.878,P＜0.05),and the change of tumor maximal diameter was also significant (t=7.054,P＜0.05).The negative correlation was detected between the ADC before treatment and the maximal diameter change ratio after 4 weeks of treatment (r2=-0.474,P＜0.05).In the group of responders,there was significant difference between the ADC value before treatment and 1 week after treatment (P＜0.05).There was significant difference in ADC value between the groups of responders and non-responders after 4 weeks of treatment (P＜0.05).The Bland-Altman analysis showed good reproducibility among the operators.Conclusion The ADC value after 1 week of targeted therapy is more sensitive to the change of tumor than the maximal diameter,and the ADC value before treatment has a certain value in predicting the maximum diameters of the target after 4 weeks of targeted therapy with repeatability.
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Objective To investigate the value of diffusion kurtosis imaging (DKI) in differential diagnosis of parotid gland disease and diagnosis of parotid adenolymphoma (PAL).Methods DKI and DWI data of 57 patients with parotid gland disease were etrospectively analyzed.Totally 57 cases were divided into infectious lesions group (n=10),pleomorphic adenoma group (n=19),PAL group (n=14),other benign parotid tumor group (n=4) and malignant parotid tumor group (n=10).Contralateral normal parotid glands in 19 patients with unilateral parotid gland lesions were treated as control group.The quantitative parameters including kurtosis concerning parameters (K Krad,Kax),diffusivity concerning parameters (D Drad,Dax),fractional anisotropy (FA) and conventional apparent diffusion coefficient (ADC) values were retrospectively reviewed.The binary Logistic regression method was used to confirm parameters with significant difference in diagnosing PAL.And Logistic regression equation was constructed to diagnose PAL.ROC analysis was conducted to evaluate the diagnostic value of the confirmed parameters and the Logistic regression equation.Results Significant difference of the parameters including K Krad,Kax,D Drad,Dax,FA and ADC values were found among different groups (all P＜0.05).ROC analysis demonstrated a higher area under the curve (AUC) for FA+Kax [0.88±0.06 (0.79-0.94)] than Kax[0.80±0.07 (0.70-0.88)] and FA [0.63±0.10 (0.52-0.73)],respectively (both P＜0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value was 71.43％,95.78％,91.77％,76.92％ and 94.44％.Conclusion DKI showed high diagnostic capacity in differential diagnosis of parotid gland disease.The combination of FA and Kaxcan improve the diagnostic accuracy in diagnosis of PAL.
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This article sorted out research results of traditional Chinese herbal medicine at home and abroad, cleared up confirmed traditional Chinese herbal medicine with estrogen activity, analyzed the function classifications, and reviewed relevant clinical research progress. It also discussed the concept and connoation of traditional Chinese herbal medicine with estrogen activity, and proposed that the research on traditional Chinese herbal medicine with estrogen activity should clarify whether “bidirectional effect” establishes and the preconditions and requirements of the establishment, with a purpose to solve the security problems about hormone dependency caused by TCM therapy. Meanwhile, the problems about quick-screening experiments, standard establishment, and the transformation of experimental achievements to clinical application are waiting to be solved.
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Objective To systematically evaluate the effectiveness and safety of glucoside tripterygium total (GTT) combined with antihistamine medicine for chronic idiopathic urticaria (CIU). Methods All randomized or semi-randomized controlled trials (RCTs or semi-RCTs) of GTT in treating CIU were collected from CNKI, VIP, WanFang Data, CBM, Embase, PubMed and Cochrane Library clinical controlled trials database. After two researchers conducted screening and data extraction independently, the quality of the included literature research was evaluated according to the risk of bias tool described in the Cochrane Handbook version 5.1.0, and then RevMan 5.3 was used to undertake Meta analysis. Results A total of 21 articles about RCTs and semi-RCTs were obtained, including 2194 patients. Meta analysis indicated that GTT combined with antihistamine medicine treatment showed higher effective rates compared with the control group [RR=1.33, 95%CI (1.26, 1.40), P<0.000 01], with obviously lower recurrence rate [RR=0.45, 95%CI (0.33, 0.62), P<0.000 01]. There was no statistical significance in adverse reactions. Conclusion GTT combined with antihistamine medicine for CIU has definite efficacy, and is relatively safe. Whether apply GTT combined with antihistamine medicine for CIU should be verified through randomized controlled trial with large-scale samples, multiple centers and high quality.
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To explore the effect of total flavones from hawthorn leaf on (THFL) on the expression of COX-2/Nrf2 in the liver tissues of rats with nonalcoholic steatohepatitis (NASH), and discuss its anti-NASH mechanism, thirty-two SD rats were randomly divided into the normal group, model group, THFL high dose group and low dose group, 8 in each group. High fat diet was given to the rats for 12 weeks to establish the NASH models, and the high and low dose groups were administered with TFHL at the dosage of 250, 125 mg•kg⁻¹•d⁻¹ respectively. Steatosis and the inflammatory changes of the liver tissues in rats were observed by HE staining; T-AOC level was detected by colorimetry; the level of 8-OHdG and the protein expressions of COX-2, Nrf2 and HO-1 in the liver tissues were determined by immunohistochemistry; and the mRNA expressions of COX-2, Nrf2 and HO-1 in liver tissues were detected by Real time-PCR. Compared with the normal group, the liver steatosis, ballooning degeneration for inflammatory degree and NAFLD activity scores (NAS) were significantly increased in model group, while total antioxidant capacity (T-AOC) was decreased, DNA damage marker 8-OHdG level was increased, and the mRNA and protein expressions of COX-2, Nrf2 and HO-1 were significantly increased. After the administration of high and low dose of TFHL, the inflammation degree of the liver tissues and NAS were significantly decreased, 8-OHdG level and COX-2mRNA and protein expressions were decreased, and the mRNA and protein expressions of Nrf2 and HO-1 were significantly increased when compared with the model group. COX-2/Nrf2 pathway was involved in the development and progression of NASH induced by high fat diet. TFHL could prevent the development of NASH by promoting the expression Nrf2/HO-1, regulating and inhibiting the over expression of COX-2, and further attenuating the cell injury and hepatic inflammation caused by oxidation reaction.