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This study aims to provide evidence for clinical practice by systematically reviewing the efficacy and safety of Gusongbao preparation in the treatment of primary osteoporosis(POP). The relevant papers were retrieved from four Chinese academic journal databases and four English academic journal databases(from inception to May 31, 2022). The randomized controlled trial(RCT) of Gusongbao preparation in the treatment of POP was included after screening according to the inclusion and exclusion criteria. The quality of articles was evaluated using risk assessment tools, and the extracted data were subjected to Meta-analysis in RevMan 5.3. A total of 657 articles were retrieved, in which 15 articles were included in this study, which involved 16 RCTs. A total of 3 292 patients(1 071 in the observation group and 2 221 in the control group) were included in this study. In the treatment of POP, Gusongbao preparation+conventional treatment was superior to conventional treatment alone in terms of increasing lumbar spine(L2-L4) bone mineral density(MD=0.03, 95%CI[0.02, 0.04], P<0.000 01) and femoral neck bone mineral density, reducing low back pain(MD=-1.69, 95%CI[-2.46,-0.92], P<0.000 1) and improving clinical efficacy(RR=1.36, 95%CI[1.21, 1.53], P<0.000 01). Gusongbao preparation was comparable to similar Chinese patent medicines in terms of improving clinical efficacy(RR=0.95, 95%CI[0.86, 1.04], P=0.23). Gusongbao preparation was inferior to similar Chinese patent medicines in reducing traditional Chinese medicine syndrome scores(MD=1.08, 95%CI[0.44, 1.71], P=0.000 9) and improving Chinese medicine syndrome efficacy(RR=0.89, 95%CI[0.83, 0.95], P=0.000 4). The incidence of adverse reactions of Gusongbao preparation alone or combined with conventio-nal treatment was comparable to that of similar Chinese patent medicines(RR=0.98, 95%CI[0.57, 1.69], P=0.94) or conventio-nal treatment(RR=0.73, 95%CI[0.38, 1.42], P=0.35), and the adverse reactions were mainly gastrointestinal discomforts. According to the available data, Gusongbao preparation combined with conventional treatment is more effective than conventional treatment alone in increasing lumbar spine(L2-L4) bone mineral density and femoral neck bone mineral density, reducing low back pain, and improving clinical efficacy. The adverse reactions of Gusongbao preparation were mainly gastrointestinal discomforts, which were mild.
Subject(s)
Humans , Bone Density , Low Back Pain , Medicine, Chinese Traditional , Osteoporosis/drug therapyABSTRACT
@#BACKGROUND: The predictive scoring systems for early stent thrombosis (EST) remains blank in China. The study aims to evaluate the risk factors and conduct a prediction model of EST in the Chinese population. METHODS: EST was defined as thrombosis that occurs within the first 30 days after primary percutaneous coronary intervention (PCI). Patients from ten Chinese hospitals diagnosed as stent thrombosis (ST) from January 2010 to December 2016 were retrospectively included as the study group. A control group (1 case:2 controls) was created by including patients without ST, major adverse cardiovascular events, or cerebrovascular events during follow-up. The present study evaluated 426 patients with single-vessel lesions and ultimately included 40 patients with EST and 80 control patients, who were included to identify factors that predicted EST and to develop a prediction scoring system. The other 171 patients without integrated 1:2 pair were used for external validation. RESULTS: EST was independently associated with a low hemoglobin concentration (adjusted odds ratio [OR] 0.946, 95% confidence interval [95% CI] 0.901-0.993, P=0.026), a high pre-PCI Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (OR 1.166, 95% CI 1.049-1.297, P=0.004), and a DAPT (DAPT) duration of <30 days (OR 28.033, 95% CI 5.302-272.834, P<0.001). The simple EST prediction score provided an area under the curve (AUC) of 0.854 (95% CI 0.777-0.932, P<0.001) with 70.0% sensitivity and 90.0% specificity, and 0.742 (95% CI 0.649-0.835, P<0.001) with 54.5% sensitivity and 81.0% specificity for external validation dataset. CONCLUSIONS: EST may be independently associated with DAPT discontinuation within 30 days, a low hemoglobin concentration, and a high SYNTAX score. The scoring system also has a good ability to predict the risk of EST and may be useful in the clinical setting.
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Purpose To study the clinicopathologic characteristics,immunophenotype and Epstein-Barr virus (EBV) infection in infectious mononucleosis (IM),and to enhance the knowledge and diagnosis of the disease.Methods The clinical data,laboratory examination,and lymph nodes biopsy of 9 cases of IM were collected.Immunohistochemistry of EliVision twostep,flow cytometry and EBER in situ hybridization double labeling were studied in 9 cases.Relevant literatures were also reviewed.Results The average age of 9 cases of IM was 22 years old.Patients presented with acute onset,short disease duration,fever,and liver,spleen and lymph node enlargement,and increased abnormal lymphocyte.Also,it was positive in the antiEBV VCA-IgM detection.EBV-DNA copy numbers were all increased.Most WBC counts were increased.Liver function index was abnormal.The ratio of peripheral blood lymphoeytes obviously increased and the ratio of atypical lymphocyte was greater than 10％.Immunophenotype of peripheral blood flow cytometry was characterized by high expression of T cells markers and CD8.CD4 expression was significantly reduced or even not expressed.CD4+/CD8 + ratio was reversed.Lymph nodes were destroyed in different extent and presented mottling without the thickening of the capsule and interstitial fibrous hyperplasia.B cells differentiation spectrum was visible.The lesion cells were mostly CD3-positive cells.CD20,CD30-positive activated cells and immunoblast cells diffused distribution and showed different degrees of strength.The site of EBER in situ hybridization was mainly in T region.Conclusion IM is an EBV-related acute self-limiting lymphoproliferative disease.Taking clinical characteristics,morphology,EBV infection and immunophenotype into considerations will help to correct diagnoses.
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Relaxin is known to inhibit cardiac fibrosis. However, it is unclear whether relaxin could regulate the effects of Phorbol 12-myristate 13-acetate (PMA, PKC activator) on cardiac fibrosis. So the influence of relaxin on the cell proliferation and collagen expression induced by PMA in cultured cardiac fibroblasts was studied. It showed that PMA significantly increased cardiac fibroblasts proliferation, Type I pro-collagen protein expression, Type I pro-collagen mRNA expression, and rhRLX absolutely significantly decreased PMA induced effects on cardiac fibroblasts proliferation and Type I pro-collagen expressions, indicating that relaxin could inhibit cardiac fibrosis induced by PMA.
Subject(s)
Animals , Rats , Animals, Newborn , Cells, Cultured , Fibroblasts , Pathology , Fibrosis , Heart Diseases , Pathology , Rats, Sprague-Dawley , Relaxin , Therapeutic Uses , Tetradecanoylphorbol AcetateABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical effect of intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation.</p><p><b>METHODS</b>From February 2005 to February 2010, 73 patients with far lateral lumbar disc herniation were treated with intertransverse approach microendoscopic discectomy. Their clinical data were retrospectively analyzed. There were 41 males and 32 females, aged from 19 to 80 years old with an average of 56.5 years; courses of disease ranged from 1 to 25 months with an average of 4.5 months. The main symptom was low back pain and sciatica, especially the sciatica was seriously. Herniation level was in L3,4 of 9 cases, L4,5 of 49 cases, L5S1 of 15 cases. Preoperative, 2 weeks after operation, final follow-up, conditions of pain relief were assessed by visual analogue scale (VAS); total life quality of patients were evaluated by Oswestry Disability Index (ODI) before operation and last follow-up.</p><p><b>RESULTS</b>All operations were performed successfully, operative time was from 40 to 115 min (mean of 50 min); and blood loss was from 50 to 150 ml (mean of 110 ml). Incision infection had 1 case and incomplete nerve root injury had 1 case. All patients were followed up from 3 to 8 years with an average of 4.5 years. Postoperative VAS and ODI had obviously improved (P < 0.01).</p><p><b>CONCLUSION</b>The technique of intertransverse approach microendoscopic discectomy is a feasible and effective method for far lateral lumbar disc herniation.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Diskectomy , Methods , Endoscopy , Methods , Intervertebral Disc Displacement , General Surgery , Lumbar Vertebrae , General Surgery , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To explore the current status of morning blood pressure and medication of hypertensive patients in Beijing.</p><p><b>METHODS</b>This study included 2187 hypertensive patients who visited the ambulance of our cardiology department in the morning (7:00-10:00) from March 2012 to April 2012. Patients were divided into three groups: no antihypertensive agent group, single antihypertensive drug therapy group (include CCB, ARB, ACEI, β-blocker) and combined drug therapy group at least one month. Blood pressure control rate was compared among the groups.</p><p><b>RESULTS</b>Target blood pressure was not reached in 1193 patients (54.6%), most patients took CCB and the target blood pressure was not reached in 61.7% (295/478) patients taking CCB. There was no significant difference on target blood pressure uncontrolled rate among the four single drug subgroups (CCB, ARB, ACEI, β-blocker). The blood pressure uncontrolled rate was 46.3% (63/136) for amlodipine, 70.5% (55/78) for nifedipine and 73.8% (31/42) for felodipine. There OR of uncontrolled blood pressure rate was 0.36 (amlodipine vs. nifedipine, 95%CI:0.20-0.65) and 0.31% (amlodipine vs. felodipine, 95%CI:0.14-0.66).</p><p><b>CONCLUSION</b>The morning blood pressure uncontrolled rate is high in hypertensive patients visiting Beijing tertiary hospitals. Amlodipine is possible superior to nifedipine and felodipine on morning blood pressure control in this patient cohort.</p>