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@#AIM: To compare the therapeutic effects of lacrimal duct retrograde catheterization, double loop antegrade catheterization, and lacrimal duct U-shaped catheter for patients with lacrimal duct obstruction.<p>METHODS: Totally 108 patients with lacrimal duct obstruction who were treated in our hospital from July 2015 to June 2018 were selected as subjects and prospectively studied. They were randomly divided into three groups: A(36 cases), B(36 cases), and C(36 cases). In group A, lacrimal duct retrograde catheterization was performed. Group B was treated with double-loop antegrade catheterization. Group C was treated with lacrimal duct U-shaped catheterization. All patients were followed up for 6mo. The intraoperative basic conditions(Lntraoperative blood loss, operation time, hospital stay), treatment efficacy, and the occurrence of complications and recurrence of lacrimal duct obstruction of the three groups were compared. <p>RESULTS: There were significant differences in the amount of intraoperative blood loss, operation time and hospital stay between the three groups(<i>P</i><0.05). The total effective rate of treatment in group A was 91.7%, which was lower than 94.4% in group B and 97.2% in group C, but the difference in total effective rate between the three groups was statistically significant(<i>P</i>>0.05). The complication rate was 11.1% in group A, 5.6% higher than that in group B, and higher than 2.8% in group C(<i>P</i>=0.010). The recurrence rate of lacrimal duct obstruction in group A was 9.1%, higher than 5.9% in group B, higher than that in group C(<i>P</i>=0.029).<p>CONCLUSION: Retrograde catheterization of the lacrimal duct, double-loop antegrade catheterization, and lacrimal duct U-shaped tube for the treatment of patients with lacrimal duct obstruction have higher therapeutic effects, postoperative complications and less recurrence of lacrimal duct obstruction, but lacrimal passage Retrograde catheterization can reduce the amount of intraoperative blood loss, operation time, and U-shaped catheterization of the lacrimal duct can reduce the length of hospital stay, and can be widely used in clinical practice.
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@#AIM:To observe and compare the therapeutic effects of intense pulsed light(IPL)combined with meibomian gland massage and eyelid fumigation massage on dry eyes associated with meibomian gland dysfunction(MGD).<p>METHODS: This study was a prospective randomized controlled clinical trial. Totally 73(146 eyes)outpatients with MGD-related dry eyes were selected from March 2018 to August 2018 at Xi'an No.4 Hospital. 38 patients(76 eyes)in the experimental group were given IPL combined meibomian gland massage treatment(once every three weeks, three times in all), and 35 patients(70 eyes)in the control group were given eyelid fumigation combined meibomian gland massage treatment(fumigating and cleaning the eyelid margin every day for 5d, massaging the tarsal gland on the fifth day, repeating treatment after 2wk, totally 3 times). The study lasted 12wk. The ocular surface disease index(OSDI), standard dry eye assessment questionnaire(SPEED), non-invasive tear film rupture time(NITBUT), non-invasive lacrimal river height measurement(NITMH), meibomian gland loss score(MGS), meibomian gland secretion assessment(MGYSS)before and after the first treatment, the first week, the fourth week, the seventh week and the twelfth week were recorded to evaluate the curative effect of the two treatments.<p>RESULTS: There was no significant difference in gender and age between the two groups(<i>P</i>>0.05).There was no significant difference in data between the two groups before treatment(<i>P</i>>0.05). Indexes except NITMH and MGS each time point after treatment in the two groups were significantly improved compared with those before treatment, and the difference was statistically significant(<i>P</i><0.05). There was no significant difference in each index between the experimental group and the control group at 1wk after treatment(<i>P</i>>0.05); at 4, 7 and 12wk after treatment, the experimental group was superior to the control group except for NITMH and MGS, and the difference was statistically significant(<i>P</i><0.05). From the change trend of the indicators, the therapeutic effect of the experimental group continued to improve after the first treatment, and was the best at the 12th week, while that of the control group was the best at the 7th week after the first treatment, and then the curative effect was weakened. There were no obvious complications in both groups after treatment.<p>CONCLUSION: Both intense pulsed light combined with palpebral gland massage and eyelid fumigation massage are convenient, safe and effective for MGD-related dry eyes, and the curative effect and maintenance time of intense pulsed light combined with palpebral gland massage are better than that of eyelid fumigation massage.
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Objective To systematically evaluate the clinical effect and safety of repaglinide and metformin for treating diabetes mellitus (MD) of secondary failure of sulfonylurea (SFS).Methods The randomized controlled trials (RCT) at home and abroad on the comparison of effect and safety of repaglinide and metformin in treating MD with SFS were retrieved.The modified Jadad scale was employed to evaluate the literature quality.The RevMan5.3.1 software was used for conducting the meta analysis.Results A total of 10 RCT were included.The meta-analysis results showed that compared with metformin for treating MA with SFS,repaglinide decreased the fasting blood glucose effectively (MD=-2.30,95 ％ CI:-2.53--2.06,P＜0.01),increased the fasting C-peptide (MD=0.06,95％CI:0.02-0.11,P=0.01),reduced the postprandial 2 h blood glucose (MD=-2.17,95 ％CI:-2.44-1.89,P＜0.01) and decreased glycosylated hemoglobin (MD=-2.60,95％CI:-3.21--2.00,P＜0.01) as well as the adverse reactions (RR=0.05,95％CI:0.02-0.09,P＜0.01).However,there was no statistical difference in fasting insulin between the repaglinide and metformin groups (MD=0.18,95％CI:-0.18-0.54,P=0.32).Conclusion Currently evidences suggest that repaglinide is superior to metformin for treating MD with SFS.
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Objective To observe the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP)biliary stent implantation and percutaneous transhepatic cholangiography(PTCD)in the treatment of malignant obstructive jaundice(MOJ).Methods Eighty-eight patients with MOJ treated in the Second Affiliated Hospital of Hainan Medical University from January 2013 to March 2016 were selected and then randomly divided into ERCP group and PTCD group,44 cases in each group.ERCP group received biliary tract stent implantation via ERCP pathway, and PTCD group underwent percutaneous transhepatic biliary puncture.The success rate,clinical efficacy,liver function and complication rate of the two groups were compared.Results The success rate of ERCP group was 93.18%(41/44),and the success rate of PTCD group was 90.91%(40/44).There was no significant difference between the two groups(P>0.05).In terms of the clinical curative effect,the total effective rate of ERCP group was 92.68%(38/41),the total effective rate of PTCD group was 90.00%(36/40),there was no significant difference between the two groups(P>0.05);the low obstruction efficiency in ERCP group was significantly higher than that of PTCD group(100.00%vs.75%),the high obstruction efficiency in ERCP group was significantly higher than that of PTCD group (96.43% vs.83.33%),the differences between the groups were statistically significant(χ2=3.503,2.771,P<0.05);in terms of the liver function recovery after treatment,the liver function index of patients with low obstruction in ERCP group were better than that in patients with high obstruction,while in PTCD group,patients with high obstructive had better liver function,compared to the low obstruction patients,the differences were statistically significant(P<0.05); the complication rate in ERCP group and PTCD group were11.36% and 15.91%,the difference was not statistically significant(P>0.05).Conclusion The ERCP pathway and PTCD pathway implantation of biliary metal stent have great clinical efficacy,while in comparison,ERCP pathway performs better in low obstruction and PTCD pathway was more suitable in high obstruction.In the course of clinical treatment,the selection of surgical approach should be based on the different obstruction sites of the patients,so as to obtain the best therapeutic effect.
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Objective To observe the clinical effect of Salmeterol xinafoate and fluticasone propionate powder for inhalation in patients with chronic obstructive pulmonary disease.Methods 70 patients diagnosed with chronic obstructive pulmonary disease from March 2014 to March 2015, were randomly divided into two groups ( n =35 ) .Control group were given basic treatment, observation group was given Salmeterol xinafoate and fluticasone propionate powder for inhalation on the basis of control group , patients were followed up and changes of related indicators wererecorded. Results After treatment one month, serum airway remodeling index b-FGF, TIMP-1 values were (93.86 ±17.36 μg/L, 38.06 ±4.28ng/mL) respectively, more than control group(135.03 ±16.06μg/L, 53.95 ±4.15ng/mL)(P<0.05).After treatment one month, inflammatory markers IL-8, TNF-αwere(7.26 ±1.57 pg/mL, 4.29 ±1.02 ng/L)respectively, were more than the control group (14.27 ±1.71 pg/mL, 8.90 ±1.21 ng/L) (P<0.05).After treatment, the observation group, the total effective rate was 91.43%, higher than 77.14%(P <0.05).Conclusion Salmeterol xinafoate and fluticasone propionate powder for inhalation has good effect in treatment of chronic obstructive pulmonary disease , better than the use of basic treatment alone.
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Objective: To compare the curative effect of Fritillariae Cirrhosae Bulbus (FCB) in six species from five origins on recurrent asthma in mice. Methods: Eighty one female Kunming mice were randomly divided into nine groups with equal weights, such as model, control, Dexamethasone (DEX, positive control), and six FCB groups. The mice in the model, DEX, and FCB groups were sc injected with ovalbumin (OVA) on days 1, 7, and 14, then challenged with the aerosols of normal saline contained OVA on days 22-28. The mice in DEX and FCB groups were ig administered with DEX (0.6 mg/kg) and FCB (830 mg/kg) respectively for 28 d, and the mice in the control group were given 0.1% carboxymethyl cellulose. The surface tension of bronchoalveolar lavage was measured, the lung tissues were taken for hematoxylin-eosin (HE) staining, and the tracheal stenosis and volume difference of pulmonary alveolus were analyzed by the microphotograph. Results: Compared with the control group, the tracheal stenosis, surface tension, and volume difference of pulmonary alveolus were increased obviously in the model group (P < 0.01). The pathological section revealed vessel wall thickening in bronchiole, inflammatory cell infiltrating, gland hyperplasia, and mucus hypersecretion, but FCB could reverse these pathological changes (P < 0.01). Each FCB had its feature to cure asthma. F. unibracteata and F. delavayi had the most potency on increasing alveolar surfactant; F. unibracteata and F. taipaiensis had the most potency on attenuating tracheal stenosis; F. unibracteata and F. przewalskii had the most potency on relieving the inflammation; F. unibracteata and F. taipaiensis had the most potency on reducing glandular hyperplasia or intimal thickening. Each FCB had its feature to cure asthma, but F. unibracteata was the best. Conclusion: FCB has the best potency to prevent and cure the recurrent asthma in mice, but each FCB has its feature. The diversity of FCB species should be protected.
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OBJECTIVE: To carry out a comparison between the cortexes and the roots of Polygala tenuifolia, and to supply references for developing scientific processing method of P. tenuifolia. METHODS: A comprehensive comparison was made by comparing the chemical constitution and pharmacological activities of the cortexes and the roots of P. tenuifolia, i.e., multi-components determination and fingerprint analysis were used to analyze their chemical constituents, and the traditional pharmacological actions of P. tenuifolia, such as cough-relieving, sputum-removing and sedative effects were used to evaluate their efficacy. RESULTS: The chemical constitution of the cortexes, roots and heartwoods of P. tenuifolia was similar, but the contents of the various effective components in the cortexes were more than those in the roots and heartwoods. The pharmacological result revealed that there was no obvious difference between the cortexes and the roots of P. tenuifolia for their activities of cough-relieving, sputum-removing and sedative actions. The roots of P. tenuifolia showed a better tendency than the cortexes for cough-relieving and sputum-removing activities. CONCLUSION: In order to avoid the waste of crude drugs, and to save the cost during heartwood-discarding, the heartwoods of P. tenuifolia are suggested to be kept.