ABSTRACT
@#Objective To investigate the effect of simvastatin and mechanical pretreatment on intimal hyperplasia of venous graft and its mechanism. Methods Twelve New Zealand rabbits were selected and randomly divided into 4 groups: a blank control group, a simvastatin topical treatment group, a mechanical precondition group and a combined group (n=3 in each group). Ultrasound was used to evaluate the changes of graft wall and blood flow velocity in the graft, and pathological section was used to evaluate the intimal hyperplasia. Human umbilical cord endodermal cells were cultured in vitro. A simvastatin group and a solvent control group were set to detect YAP phosphorylation, downstream target gene expression and cell proliferation. Results Vascular ultrasound showed that except the simvastatin topical treatment group, the flow velocity in vein grafts in the other three groups significantly increased 21 days after surgery compared with 7 days after surgery (P<0.01). Pathological sections showed that the thickness of new intima in the simvastatin topical treatment group, mechanical precondition group, combined group and blank control group were 45.56±4.11 μm, 201.28±16.71 μm, 143.57±7.82 μm, 249.45±13.33 μm, respectively, and there were statistical differences compared with the blank control group (P<0.05). In vitro results showed that compared with the solvent control group, cell death was observed in high concentration simvastatin (5 mmol/L) group, cell proliferation was inhibited in low concentration simvastatin (2.5 mmol/L) group (P<0.05), the expression of YAP protein in the simvastatin group was unchanged, but the expression of phosphorylated YAP protein significantly increased (P<0.05), and the expression of downstream target gene ccn1 was down-regulated (P<0.001). Conclusion Intravascular local application of simvastatin and mechanical preconditioning alone or in combination can inhibit intimal hyperplasia of venous graft. High concentration of simvastatin has cytotoxicity, while low concentration of simvastatin has inhibitory effect on cell proliferation. Simvastatin can inhibit the formation of new intima by inhibiting the entry of YAP into the nucleus and reducing the transcription of cell proliferation-related target gene ccn1.
ABSTRACT
Objective To investigate the effect of tranexamic acid (TXA) on blood coagulation and fibrinolysis in patients undergoing spinal surgery. Methods From October 2017 to October 2018, 96 patients, who underwent multi-segment, thoracolumbar posterior bone graft fusion and internal fixation in the Spinal Surgery Department of Daping Hospital, Army Medical University, were selected and randomly divided into 4 groups (24 each): control group (flushing incision with normal saline), intravenous drip group (intravenous drip of 1% TXA injection), 0.5% TXA group (0.5% TXA injection applied on the incision) and 1% TXA group (1% TXA injection applied on the incision). The incision drainage of each group was measured on the 1st, 2nd and 3rd day after operation, the five indicators of coagulation [activated partial prothrombin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), and International standardized ratio (INR)] were measured before operation and the 1st, 2nd and 3rd day after operation. The level of D-dimer (D-D) was determined by immunoturbidimetry. Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) were detected by ELISA. The maximum thrombus amplitude (MA), reaction time (R), coagulation time (K), coagulation angle (Angle) and fibrinolytic activity value (LY30) were measured by the thrombus elastic diagram (TEG). Finally, double lower limb B-ultrasonography was performed 1 day before discharge. B-ultrasound examination of lower extremities was performed one day before discharge. Results On the 1st, 2nd and 3rd day after surgery, the drainage volume was less in intravenous drip group, 0.5% TXA group and 1% TXA group than in the control group in the same period (P0.05). On the 1st, 2nd and 3rd day after surgery, the D-D level was lower in intravenous drip group, 0.5% TXA group and 1% TXA group than in the control group (P0.05). On the first day after surgery, MA was higher in intravenous drip group, 0.5% TXA group and 1% TXA group than in the control group (P0.05). No significant difference existed in R, K, Angle and LY30 among the 4 groups and within the same group between different time points (P>0.05). B-ultrasound showed no deep venous thrombosis in both lower limbs one day before discharge. Conclusion Local application of TXA with same dosage in spinal surgery may play a better antifibrinolytic and hemostatic effect than intravenous application of TXA.
ABSTRACT
OBJECTIVE: To evaluate the efficacy,safety and tolerability of recombinanat human interferon α2 b(rhIFNα2b)spray in treatment of acute upper respiratory tract infection(except the flu)in children. METHODS: In total,575 children who met the inclusion criteria were enrolled from January,2019 to July,2019. They were divided into rhIFNα2b spray group(291 cases)and ribavirin group(284 cases). The children in rhIFNα2b spray group were given the rhIFNα2b spray(P.putida),and those in ribavirin groups were treated with the ribavirin spray. The curative effect and safety between the two groups were compared. RESULTS: The per-protocol set(PPS) comprised 448 patients(233 in the rhIFNα2b spray group,215 in the ribavirin group). The primary efficacy endpoint was antipyretic time which in rhIFNα2b spray group(25.0 h)was significantly shorter than that in the ribavirin group(33.6 h)(P=0.0001). In the comparison of symptomatic relief time,the relief time of nasal congestion,runny nose,sore throat and cough in rhIFNα2b spray group was shorter than that in ribavirin group(P<0.05). The recovery time in the rhIFNα2b spray group was 92 h,which showed significant decrease compared with the ribavirin group(112 h)(P<0.0001). The incidence of adverse events had no statistical differences between the two groups(P=0.2461). CONCLUSION: The rhIFNα2b spray treatment for acute upper respiratory tract infection in children is proved to be significantly effective;particularly,it can evidently relieve fever symptoms and promote the disappearance of nasal and pharyngeal symptoms. It has good safety and tolerability,so the rhIFNα2b spray is worthy to be promoted in clinical application.
ABSTRACT
Background: Surgical site infection is a common cause of morbidity for the operated patients. Hence a cost effective and simple method was formulated and studied on cases of laparotomy and appendicectomy patients which can be categorized as dirty and contaminated wounds. Materials and methods: 25 cases and adequately matched controls were selected from patients who underwent laparotomy or appendicectomy which can be categorized as dirty or contaminated wounds. Cases were given local application Inj. Amikacin over the subcutaneous plane preoperatively and for the subsequent three post-operative days through a subcutaneously placed feeding tube along with systemic iv antibiotics. The control patients only received systemic IV antibiotics. ASEPSIS scoring was used to grade the post-operative surgical site infection in the cases and the corresponding controls, at the end of the first and second week after surgery. Various criterions were specifically evaluated such as the isolation of microbe from the wound site or the requirement of change of antibiotic at the end of the 1st or 2nd week and the tendency of prolonged stay in the hospital for more than 2 weeks. Results: It was observed that the cases that received the local Amikacin application as an adjuvant to systemic antibiotic showed significantly lesser incidence and/ or grading of SSIs in the first week and A.K. Rajendran, C. Arun Babu, Gnana Sezhian. To evaluate efficacy of local Amikacin therapy as an adjuvant to parenteral antibiotics in control of surgical site infection compared to parenteral antibiotic alone in a tertiary care centre. IAIM, 2018; 5(2): 64-71. Page 65 also lesser, but not statistically significant reduction of SSIs in the second week. The incidence of antibiotic change, hospital stay and isolation of microbe from the wound site was statistically found be to lesser in the study group compared to their controls. Conclusion: It is observed that the local therapy as an adjuvant is cost effective and without any significant local or systemic adverse effects in the prevention of SSIs in dirty and contaminated patients. But it was also observed that it did not have sustained effect for prolonged period beyond its time of administration (as evidenced by its lesser effect in the second week after surgery). It may be suggested that a further combination of suction drainage of the subcutaneous DT along with local antibiotic treatment may have added advantage in further preventing SSIs.
ABSTRACT
OBJECTIVE:To systematically evaluate therapeutic efficacy of local application of gentamicin collagen sponge in the prevention of surgical incision infection,and to provide evidenced-reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,VIP and Wanfang databases,randomized controlled trials (RCTs) about lo-cal application of gentamicin collagen sponge(trial group)vs. routine surgery disposal(control group)in the prevention of surgical incision infection were collected. After data extraction and quality evaluation with modified Jadad scale,Meta-analysis was per-formed by using Rev Man 5.3 statistical software. RESULTS:A total of 16 literatures were included,involving 7752 patients. The results of Meta-analysis showed that the incidence of surgical incision infection in trial group was significantly lower than control group,with statistical significance [OR=0.71,95%CI(0.61,0.84),P100 mg) was significantly lower than control group;there was no statistical significance between gentamicin low-dose group (≤100 mg) and control group [OR=0.96,95%CI(0.72,1.28),P=0.77]. CONCLUSIONS:Local application of gentamicin collagen sponge may have certain effect on the prevention of surgical infection. Different types of surgery,observation time and dose have different prevention effects. It should be used carefully according to clinical practice.
ABSTRACT
Objective To study the clinical effect of Periocline ointment as the auxiliary treatment of chronic periodontitis. Methods 100 cases of chronic periodontitis in our hospital were selected as the subjects (from May 2016 to June 2017). The patients in the experimental group and the control group underwent periodontal examination, and the baseline was recorded. The control group was treated with routine treatment, the patients treated on the basis of analysis of Periocline ointment in the treatment of two groups of patients treated for 4 weeks. Results After treatment, the patients in the experimental group for attachment level (4.84±0.74) mm, probing depth (3.45±0.47) mm, bleeding index for (2.43±0.52) was significantly better than the control group related clinical indicators of periodontal probing depth and attachment level, with statistical significance (P<0.05). The number of effective cases in the experimental group was 47 cases (94%), significantly higher than the control group, the number of effective treatment in 44 cases (88%), the difference was statistically significant (P<0.05). Conclusion Periocline ointment as the auxiliary treatment of chronic periodontitis can improve the treatment efficiency, improve clinical indexes of patients, is worthy of clinical application.
ABSTRACT
Objective To study the clinical effect of Periocline ointment as the auxiliary treatment of chronic periodontitis. Methods 100 cases of chronic periodontitis in our hospital were selected as the subjects (from May 2016 to June 2017). The patients in the experimental group and the control group underwent periodontal examination, and the baseline was recorded. The control group was treated with routine treatment, the patients treated on the basis of analysis of Periocline ointment in the treatment of two groups of patients treated for 4 weeks. Results After treatment, the patients in the experimental group for attachment level (4.84±0.74) mm, probing depth (3.45±0.47) mm, bleeding index for (2.43±0.52) was significantly better than the control group related clinical indicators of periodontal probing depth and attachment level, with statistical significance (P<0.05). The number of effective cases in the experimental group was 47 cases (94%), significantly higher than the control group, the number of effective treatment in 44 cases (88%), the difference was statistically significant (P<0.05). Conclusion Periocline ointment as the auxiliary treatment of chronic periodontitis can improve the treatment efficiency, improve clinical indexes of patients, is worthy of clinical application.
ABSTRACT
[Abstrct] Based on field studying at University of California, Los Angeles (UCLA),discussing with the teacher and student representatives and reviewing related literatures, we found that the suc-cessful experience of PBL at UCLA were small group teaching, the use of different sources of tutor, serious case preparation, and good hardware support. The major difficulties of PBL at UCLA were high teaching costs, unstable teacher group and high hardware requirements. Because of the cultural differ-ences between East and West, Chinese students are not good at active learning, so we recommended gradually carrying out PBL teaching in our country, making more PBL skills training to teachers and students, strengthening the hardware construction, seeking school administrative support, and giving timely repair according to the feedback of scientific research.
ABSTRACT
Objective This study aimed to study the effect of intra-brachial nitroglycerin administration via the angiography catheter on radial artery spasm in transradial percutaneous coronary intervention. Methods From patients undergoing transradial percutaneous coronary intervention (TRI) and succeeding in coronary angiography (CAG), 810 patients who needed percutaneous coronary intervention (PCI) (including Percutaneous Transluminal Coronary Angioplasty and/or stent implantation) were erolled, including 413 patients in the study group and 397 patients in the control group. When coronary angiography completed, positioned the angiography catheter over brachial artery and patients in the group received an administration of 400μg nitroglycerin via the angiography catheter. The control group received an administration of 400μg nitroglycerin via the sheath. The incidence of RAS were recored and compared. Resultes Baseline characteristics were similar between two groups. In the study group, the incidence of RAS was signiifcatively lower (18 vs. 33, P=0.021). Conclusions Intra-brachial nitroglycerin administration via the angiography catheter can prevent RAS during the insertion of guiding catheter in TRI.