ABSTRACT
OBJECTIVE:To evaluate therapeutic efficacy of Aidi injection,Compound kushen injection,Kanglaite injection, Elemene injection and Brucea javanica oil emulsion injection in the treatment of malignant pleural effusion(MPE),and to provide evidence-based reference in clinic. METHODS:Retrieved from PubMed,EMBase,Cochrane library,CJFD,Wanfang database and CJFD,RCTs about Aidi injection,Compound kushen injection,Kanglaite injection,Elemene injection and B. javanica oil emulsion injection in the treatment of MPE were collected. Meta-analysis was conducted by using ADDIS 1.16.6 statistical software after data extraction and quality evaluation by modified Jadad scale. RESULTS:A total of 54 RCTs were included,involving 3404 patients. All RCTs were two legs with a total number of 108. Results of network Meta-analysis showed that compared with cisplat-in,Compound kushen injection [OR=2.19,95%CI(1.30,3.76),P<0.05],Elemene injection [OR=3.55,95%CI(2.43,5.32),P<0.05] and B. javanica oil emulsion injection [OR=1.92,95%CI(1.34,2.76),P<0.05] could significantly improve response rate of MPE patients,with statistical significance. Pairwise comparison showed response rate of Elemene injection was significantly higher than that of Aidi injection [OR=0.32,95%CI(0.17,0.56),P<0.05],Kanglaite injection [OR=0.30,95%CI(0.13,0.68),P<0.05] and B. javanica oil emulsion injection [OR=1.85,95%CI(1.10,3.17),P<0.05] in improving response rate. The probability ranking was Elemene injection>Compound kushen injection>B. javanica oil emulsion injection>Aidi injection=Kanglaite injection=cispl-atin. Compared with cisplatin,Aidi injection [OR=0.29,95%CI(0.16,0.54),P<0.05],Compound kushen injection [OR=0.44, 95%CI(0.18,0.96),P<0.05],Elemene injection [OR=0.21,95%CI(0.10,0.44),P<0.05] and B. javanica oil emulsion injection [OR=0.41,95%CI(0.23,0.70),P<0.05] could significantly improve the rate of quality of life improvement in MPE patients,with statistical significance. Pairwise comparison showed the rate of quality of life improvement of Elemene injection in MPE patients was significantly higher than that of Kanglaite injection [OR=4.84,95%CI(1.03,25.01),P<0.05]. The probability ranking was El-emene injection>Aidi injection>Compound kushen injection>B. javanica oil emulsion injection>Kanglaite injection>cisplatin.CONCLUSIONS:All 5 kinds of TCM injection can effective-ly treat MPE and improve the quality of life,among which El-emene injection is mostlikely to be the most effective interven-tion.
ABSTRACT
Objective:To explore the effect of acupuncture and rehabilitation training on the quality of survival and cognitive function of patients with brain injuries. Methods:A total of 76 patients with brain injuries treated in our department from Jan 2014 to Apr 2015 were selected as the research object (n=76) . They were randomly divided into two groups, observation group and control group, 38 in each group. The patients in control group were treated by acupuncture and routine care. The patients in observation group were treated by acupuncture and rehabilitation training. The patients' cognitive function, life quality, ability of daily life were observed. Results:Before the treatment,the LOTCA and ADL scores of both groups had no significance for statistics (P>0.05) but improved after the treatment. At 4,8 weeks after treatment,the LOTCA and ADL scores in observation group were higher than those in control group (P<0.05) WHOQOL-BREF was used to survey the quality of survival,and the scores of mental health, psychological health, interpersonal relationship and social relationship in observation group were also higher than those in control group (P<0.05) . Conclusion:Brain injury patients treated with acupuncture and rehabilitation training can improve the patients' cognitive function,ability of daily life and quality of survival,and would be conducive to the long-term prognosis,which is worthy of promotion.
ABSTRACT
Several prognostic factors have been implicated in survival prolongation in patients with metastatic brain tumors. Among these, surgery has been regarded as very significant one with respect to life prolongation and improving the quality of survival in such patients. From August 1982 through July 1996, a series of 31 patients with metastatic brain tumors among 785 patients with operated brain tumors, whose medical records, X-rays and follow-ups were avilable, was studied retrospectively to evaluate the beneficial effects of surgery. Despite the limitations inherent to the retrospective study and limited number of patients, we divided these patients into two groups to find out any statistical differences in terms of survival and quality of survival among them: 1) Conservative group(8 nonoperated patients: 5 patients with biopsy or partial resection): 13, and 2) Surgical treatment group(17 totally resected patients: one patient with subtotal resection): 18. The quality of survival was assessed by Karnofsky performance(KP) scale before and after each treatment. The survival of the patients in the surgical treatment group was longer than the conservative treatment group(14.5 months/10 months), but this was not statistically significant(p value: 0.3305). However, improvement of quality of survival, in terms of KP scale, was significantly higher in the surgical treatment group(p value: 0.0027). Although confounded by the lack of controlled, randomized study and limitations of retrospective study, aggressive surgery can be regarded to have a significant role in improving the quality of survival in patients with metastatic brain tumors.