Propensity-matched comparison of laparoscopic and open radical cystectomy for female patients with bladder cancer / 北京大学学报(医学版)

OBJECTIVE@#To compare the perioperative and oncologic outcomes of female patients receiving laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC).@*METHODS@#Retrospective review of 91 consecutive female patients with urothelial carcinoma of bladder undergoing radical cystectomy at a single academic institution from 2006 to 2017. Those female patients received open radical cystectomy were matched to the patients who underwent laparoscopic radical cystectomy by using propensity score matching in 1 ∶1 ratio. The matching factors included age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, pathologic stage and pathologic nodal stage. The perioperation and oncology characteristics were compared, and Kaplan-Meier method was used to analyze the overall survival (OS), cancer specific survival (CSS) and progression-free survival (PFS) estimates. Finally, we did a sensitive analysis by using multivariable COX regression of all the patients, adjusting for the matching factors.@*RESULTS@#There were 65 ORC and 26 LRC patients identified in this cohort with urothelial carcinoma of bladder, the median follow-up time was 38 months (interquartile range 18-69). The age (P<0.001) and ASA scores (P=0.018) were less for LRC before being matched. There were 22 LRC and 22 ORC patients matching successfully. Before being matched, the estimate blood loss (P=0.005), transfusion rate (P<0.001) and total complications rate (P=0.015) were less for LRC, and the lymph nodes yield was greater for LRC, but there were no differences in OS (P=0.698), CSS (P=0.942) and PFS (P=0.837) between the two groups. After being matched, the estimate blood loss (P=0.009), transfusion rate (P=0.001) and total complications rate (P=0.040) were less for LRC, but there was no difference in the lymph nodes yield. Besides, there were no statistic differences in OS (P=0.432), CSS (P=0.429) and PFS (P=0.284) between the two groups. In addition, in multivariable COX regression analysis, surgical approaches (LRC/ORC) were not found to be a predictor of OS (HR 1.134, 95%CI 0.335-3.835, P=0.839), CSS (HR 1.051, 95%CI 0.234-4.719, P=0.949) and PFS (HR 0.538, 95%CI 0.138-2.095, P=0.371) of the female patients with urothelial carcinoma of bladder.@*CONCLUSION@#It is advantageous for laparoscopic radical cystectomy in terms of estimating blood loss, transfusion rate and complication rate. But there was no evidence that laparoscopic radical cystectomy for female patients with bladder cancer had a better oncologic prognosis than open radical cystectomy from this study.

Isolation and Content Determination of Hydrangenol in Leaves of Hedyotis Hedyotidea (DC) Merr by HPLC / 中国中医药信息杂志

Objective To conduct isolation identification of hydrangenol and establish a method for content determination of hydrangenol in the leaves of Hedyotis hedyotidea (DC) Merr; To provide references for further development and research of Hedyotis hedyotidea;To compare the contents of hydrangenol in the leaves of Hedyotis hedyotidea of different production areas and different batches. Methods Hydrangenol showed a good linear relationship within the range of 0.412–10.300 μg (r=1.000 0), with the average recovery of 99.09% (RSD=0.53%). Good precision and repeatability were achieved with the RSDs smaller than 1.0%. The content range was 0.03%–0.38% for hydrangenol in the leaves of Hedyotis hedyotidea of different production areas and different batches, and the highest contents appeared in those from Guangxi. Conclusion The method is simple, accurate, specific, reproducible and can be used for the content determination of hydrangenol in the leaves of Hedyotis hedyotidea; the contents of hydrangenol in the leaves of Hedyotis hedyotidea of different production areas and different batches are different, and contents in samples from Guangxi and Guangdong are higher.

Literature Analysis on Administration Sequence and Antibacterial Efficacy in the Combination Use of Am-broxol and Antibacterial Agents / 中国药师

This article reviewed the pharmacokinetic and pharmacodynamic characteristics of ambroxol and the interactions be-tween ambroxol and antibacterial agents. The use order of ambroxol and antiseptic drugs was analyzed and discussed. Ambroxol was a-ble to increase antibiotics concentration in bronchoalveolar lavage fluid (BALF) samples. Besides, ambroxol could destroy the struc-ture of bacterial biofilm(BF) in a dose-dependent manner,and high dose of ambroxol hydrochloride showed good safety. When ambr-oxol and antibacterial agents were in combination use,ambroxol should be administrated before antibacterial agents in order to enhance antibacterial efficacy,since ambroxol could increase the concentration of antibacterial agents in lung and help the antibacterial agents enter the bacterial BF. It was suggested that the label of ambroxol be further improved and revised as follows:①the administration se-quence of ambroxol and antibacterial agents should be stated;②the recommended doses of ambroxol for different indications should al-so be listed in the label;③ the clinical safety and efficacy of high dose of ambroxol should be stated.

Analysis on the treatment of complicated ocular trauma accompanied with cyclodialysis / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To explore the effective method for the treatment of complicated ocular trauma accompanied with cyclodialysis.METHODS: Sixty - eight cases of complexity ocular trauma with cyclodialysis in different degrees were undergone vitrectomy and ( or ) combined with ciliary body reduction.RESULTS:All patients were followed up for 10 ~36mo (mean 17. 0±5. 7mo). The postoperative visual acuity was better than that of preoperation (P<0. 05). Compared with preoperative, intraocular pressure was significantly increased ( P < 0. 05 ). Successful rate of ciliary body restoration was 91%. CONCLUSlON: For the complicated ocular trauma accompaniedwith cyclodialysis, vitrectomy and ( or ) ciliary body reduction is an effective treatment method.

Comparative study on application of Duo positive airway pressure and continuous positive airway pressure in preterm neonates with respiratory distress syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To determine whether early application of Duo positive airway pressure (DuoPAP), in comparison with nasal continuous positive airway pressure (NCPAP), can reduce the need for endotracheal intubation and mechanical ventilation and decrease the incidence of bronchopulmonary dysplasia (BPD) in preterm neonates with respiratory distress syndrome (RDS).</p><p><b>METHODS</b>In a single-center, randomized controlled trial, preterm neonates (gestational ages 30-35 weeks) with RDS were randomly assigned to receive DuoPAP (n=34) or NCPAP (n=33) within 6 hours of birth. If the two noninvasive ventilations were not effective, endotracheal intubation and mechanical ventilation were used, and pulmonary surfactant was administered as rescue therapy. The total invasive respiratory support rate and incidence of BPD within 24, 48 and 72 hours of birth were observed. The two groups were compared in terms of PaCO2, PaO2 and oxygenation index (OI) at 1, 12, 24, 48 and 72 hours after using the noninvasive respiratory support.</p><p><b>RESULTS</b>The total invasive respiratory support rates within 48 and 72 hours after birth were significantly lower in the DuoPAP group than in the NCPAP group (P<0.05). There was no difference in the incidence of BPD between the two groups (P>0.05). The OI in the DuoPAP group was significantly higher than in the NCPAP group at 1, 12, 24, 48 and 72 hours after noninlasive respiratory support (P<0.05). The DuoPAP group showed significantly lower PaCO2 than the NCPAP group at 1, 12, and 24 hours after noninvasive respiratory support (P<0.05). PaO2 was significantly higher in the DuoPAP group than in the NCPAP group at 1 and 12 hours after noninvasive respiratory support (P<0.05).</p><p><b>CONCLUSIONS</b>Compared with NCPAP, early application of DuoPAP can decrease the need for endotracheal intubation and mechanical ventilation in preterm neonates with RDS, showing promise for broad use.</p>

Clinical observation on diabetic peripheral neuropathy treated with electroacupuncture and acupoint injection / 中国针灸

<p><b>OBJECTIVE</b>To compare the differences in the therapeutic effect on diabetic peripheral neuropathy between the combined therapy of electroacupuncture and acupoint injection and the simple acupoint injection.</p><p><b>METHODS</b>Under the satisfactory control of blood glucose, 60 cases of diabetic peripheral neuropathy were divided randomly into two groups, 30 cases in each one. In electroacupuncture plus acupoint injection group (group A), electroacupuncture and acupoint injection with Methylcobalamin were administered. Penetrating acupuncture was applied from Gongsun (SP 4) to Quanzhong (Extra) and from Yongquan (KI 1) to Taichong (LR 3) mainly. Acupoint injection was administered on Sanyinjiao (SP 6). In acupoint injection group (group B), only acupoint injection with Methylcobalamin was provided on Sanyinjiao (SP 6). After 2 sessions of treatment, the conduction velocity of ulnar nerve and tibial nerve was measured. The scores of Chinese medicine syndrome and diabetic peripheral neuropathy were recorded before and after treatment in two groups.</p><p><b>RESULTS</b>The effective rates were 90.0% (27/30) and 63.3% (19/30) in group A and group B respectively, presenting significant statistical difference (P < 0.05). After treatment, the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of ulnar nerve and tibial nerve in group A were higher than those in group B (P < 0.05, P < 0.01). After treatment, the score of Chinese medicine syndrome in group A was lower than that in group B (14.36 +/- 1.88 vs 26.58 +/- 3.52, P < 0.01), the score of diabetic peripheral neuropathy in group A was lower than that in group B (12.86 +/- 4.28 vs 17.89 +/- 4.35, P < 0.01).</p><p><b>CONCLUSION</b>Electroacupuncture and acupoint injection with Methylcobalamin achieve a significant clinical efficacy on diabetic neuropathy and its efficacy is superior to that of simple acupoint injection with Methylcobalamin. This therapy can effectively increase nerve conduction velocity, control and relieve the symptoms of diabetic peripheral neuropathy.</p>