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Introducción: Los schwanomas vestibulares son lesiones clasificadas como grado I por la Organización Mundial de la Salud. Las opciones conductuales incluyen la observación, la radiocirugía o la resección microquirúrgica endoscópica. Objetivo: Describir el rol del tratamiento multimodal en los schwanomas vestibulares. Métodos: Se realizó una búsqueda sistemática de literatura médica para la identificación e inclusión de artículos en las siguientes bases de datos: PubMed/Medline, SciELO y Google Scholar, además de los servidores de preprints BioRvix y MedRvix. Se usaron los siguientes descriptores: vestibular schwanoma OR acoustic neuroma AND nerve centered approach OR combined approach AND partial resection OR subtotal resection OR near total resection. Se excluyeron editoriales, cartas al editor, libros, revisiones, metaanálisis y aquellos artículos con método deficiente de más de 20 años de publicación o sin mención al tema de interés. Fueron incluidos 16 artículos. Desarrollo: Los artículos incluyeron un total de 699 pacientes, de los cuales solo 228 (32,6 %) recibieron radioterapia en el período posoperatorio. El período de seguimiento promedió 49,6 meses. La preservación de la función facial se logró en el 88,3 % de los casos y el control tumoral en el 80,7 %. El estado de la preservación auditiva solo fue informado en el 50 % de los estudios. El uso de la radioterapia adyuvante mostró gran variabilidad. Conclusiones: El tratamiento multimodal para los schwanomas vestibulares grandes -compuesto por la resección subtotal, vaciamiento intratumoral, seguido de radiocirugía- se ha convertido en una opción plausible. Se necesita la publicación de mayor cantidad de reportes para ofrecer recomendaciones y estratificar la conducta.
Introduction: Vestibular schwannomas are lesions classified as grade I by the World Health Organization. Behavioral options include observation, radiosurgery or endoscopic microsurgical resection. Objective: To describe the role of multimodal treatment for vestibular schwannomas. Methods: A systematic search of medical literature, for the identification and inclusion of articles, was carried out in the databases PubMed/Medline, SciELO and Google Scholar, as well as in the preprint servers BioRvix and MedRvix. The following descriptors were used: vestibular schwannoma OR acoustic neuroma AND nerve centered approach OR combined approach AND partial resection OR subtotal resection OR near total resection. Editorials, letters to the editor, books, reviews and metaanalyses were excluded, as well as articles with deficient method of more than 20 years of publication or not mentioning the topic of interest. Sixteen articles were included. Development: The articles included a total of 699 patients, of which only 228 (32.6 %) received radiotherapy in the postoperative period. The average follow-up period was 49.6 months. Preservation of facial function was achieved in 88.3 % of cases; and tumor control, in 80.7 %. Hearing preservation status was reported in only 50 % of the studies. The usage of adjuvant radiotherapy showed great variability. Conclusions: Multimodal treatment for large vestibular schwannomas -composed of subtotal resection and intratumoral draining, followed by radiosurgery- has become a plausible option. The publication of a greater amount of reports is necessary to provide recommendations and stratify the behavior.
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Given the important position and function of the hypopharynx, the preservation of organ function and survival improvement are equally important. The optimal role of multi-disciplinary combined treatment modality becoming increasingly important. The optimal laryngeal preservation strategy for hypopharyngeal cancer is under continuous exploration. With the constant research of surgery, radiotherapy, chemotherapy, and molecular targeted therapy, new laryngeal preservation strategies continue to emerge. Herein, we primarily summarize the advances in multi-disciplinary combined treatment and the future direction in the treatment of hypopharyngeal carcinoma.
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【Objective】 To investigate the efficacy of in vitro local high-frequency hyperthermia combined with drugs in the treatment of type Ⅲb chronic prostatitis (CP). 【Methods】 A total of 148 patients with type Ⅲb CP treated in our hospital during Jun.2020 and Jun.2022 were randomly divided into control group (n=74) and combination group (n=74). The control group received only drug treatment, while the combination group received extracorporeal local high-frequency hyperthermia treatment. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), maximum urinary flow rate (MFR), average urinary flow rate (AFR) and International Index of Erectile Function-5 (IIEF-5) score were compared between the two groups. 【Results】 There were no significant differences between the two groups in terms of NIH-CPSI, MFR, AFR and IIEF-5 score before treatment(P>0.05). After treatment, these indexes increased in both groups (P<0.05), and the improvements in the combination group were more significant (P<0.05). 【Conclusion】 Medication combined with in vitro local high-frequency hyperthermia is effective in improving the clinical symptoms of type Ⅲb CP, which is worth clinical promotion.
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As a basic source for the theoretical system of traditonal Chinese medicine （TCM）， the Inner Canon of Yellow Emperor （《黄帝内经》） made the point of “treatment with combination of diverse methods and prescriptions”，which is one of the characteristics of TCM in treating diseases. This paper discussed the therapeutic idea of “diverse methods and prescriptions” from five dimensions， including time， population， regions， diseases， and treatments， and proposed that “combined treatment” is an effective measure to embody the idea of “diverse methods and prescriptions”. That is to say， by taking the combination of the concept of holism and syndrome differentiation and treatment as the starting point， combining pharmacological and non-pharmacological therapies， and treating both internal and external diseases through multiple ways and methods， the goal to treat the disease at the root， and keep yin at peace and yang compact can be achieved. Finally， it is suggested to guide the clinical practice with “treatment with combination of diverse methods and prescriptions”， providing new ideas for clinical diagnosis and treatment.
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Social anxiety disorder is a common anxiety disorder in which a key feature is interpersonal avoidance accompanied by generalized problems with emotion identification and emotion regulation. In response to the gap in these therapeutic priorities in other therapies, emotion-focused therapy has emerged to fill the part of the treatment of emotions with an emphasis on the relational process. The paper reviews the recent studies related with the treatment of social anxiety disorder with emotion-focused therapy. The results suggest that the main points of social anxiety onset in an emotion-focused perspective are traumatic emotional experiences and self-criticism, and that the therapeutic focus of emotion-focused therapy is on dealing with the traumatic emotional scenario behind the anxiety and exposing it to adaptive emotions to be transformed. It also works better in combination with other more mainstream therapies. This suggests that emotion-focused therapy is a promising approach for the clinical treatment of social anxiety disorder and looks forward to the development of a more integrated treatment approach in the clinic.
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Resumen La leishmaniasis tegumentaria en Bolivia es producida mayoritariamente por L. braziliensis. Las manifestaciones clínicas son ulceras, que pueden generar lesiones satélites próximas a la inicial. Las drogas de primera elección para el tratamiento son los antimoniales pentavalentes; aunque con una eficacia variable. La falta de respuesta a estas drogas, induce al empleo de otras, consideradas como de segunda elección. Sin embargo, en todos los casos existe la posibilidad de falla terapéutica. El presente caso muestra la remisión de las lesiones usando tratamiento combinado de pentamidina, miltefosina y paromomicina, en un paciente con antecedente de falta de respuesta a la monoterapia con Glucantime®. La remisión de la enfermedad alcanzada al final de la terapia, probablemente sea resultado de la acción lítica simultánea de las tres drogas utilizadas y a la restauración de la respuesta inmune del paciente. Hasta los 21 meses de control pos tratamiento, todas las lesiones se mantuvieron cicatrizadas y ausencia de otras nuevas.
Abstract The tegumentary leishmaniasis in Bolivia is mainly caused by L. braziliensis. The clinical manifestations are ulcerative lesions which can generate satellite lesions close to the initial one. The first choice drugs for treatment are pentavalent antimonials; although with variable effectiveness. Lack of response to these drugs leads to the use of other alternatives, considered as second-choice drugs. However, in all cases there is the possibility of therapeutic failure. The present case shows the remission of the lesions using a combined treatment of pentamidine, miltefosine and paromomycin, in a patient with a history of lack of response to monotherapy with Glucantime® The remission of the disease achieved at the end of combined therapy is probably the result of the simultaneous lytic action of the three drugs used and the restoration of the patient's immune response. Up to 21 months of post-treatment control, all the lesions remained healed and the absence of new ones.
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Abstract This study assessed the performance of two pilot units, a conventional activated sludge (CAS) and an Integrated Fixed-Film Activated Sludge (IAS), in the treatment of leachate from sanitary landfill combined with domestic sewage, with the aim of removing organic substances. In order to assess the possible impacts on treatment, three experimental phases were designed using influent leachate contributions of 5%, 10%, and 20% of the total BOD load. Overall, the results showed that no significant changes in the behavior of biological processes. The IAS unit presented average BOD removal efficiencies of above 88%, 87% and 80% for the three leachate load contributions of 5%, 10% and 20% studied. The CAS unit presented lower average efficiency with a 5% leachate contribution (64%), but displayed a similar performance to the IAS unit in the other phases (82% and 80%); similar quantitative aspects were observed for both treatment processes with regards to biomass composition analysis. The kinetic coefficients related to heterotrophic metabolism did not indicate negative effects on treatment efficiency as a result of the increase in leachate addition, with values of 2.8; 2.8 and 2.7 d-1 obtained respectively for each phase with the CAS unit, and 2.0; 1.5 and 1.6 d-1 with the IAS unit, representing similar values to those found in the literature (1.5 a 5.0 d-1). The results reinforced the conclusion that the leachate load introduced did not cause inhibition or significant alterations to heterotrophic metabolism, and, therefore, to the removal of organic matter.
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Humans , Animals , Water Pollutants, Chemical/metabolism , Percolating Liquid , Activated Sludges , /methods , Biomass , Pilot Projects , Bioreactors , Heterotrophic Bacteria , Organic MatterABSTRACT
BACKGROUND: Comparative study results between the treatment efficiency of acupuncture plus other combination therapy and western medicine therapy in the treatment of knee osteoarthritis remain controversial. Currently, meta-analysis studies mainly focus on comparison of the efficacy between single acupuncture treatment, acupuncture plus western medicine combination therapy and western medicine, but there is a lack of investigation on acupuncture combined with other therapies. It is difficult to fully understand the efficacy of acupuncture. OBJECTIVE: To compare the effects of acupuncture therapy, conventional western medicine and Chinese medicine on osteoporosis treatment by network meta-analysis. METHODS: A search was performed on the CNKI, VIP, WanFang, SinoMed, PubMed, and Cochrane Library databases to include the randomized controlled trials of different acupuncture treatments for osteoporosis. Relevant data were extracted after screening the literature according to relevant inclusion and exclusion criteria, and the quality of the included literature was evaluated. Literature data analysis and mapping were performed using Stata 14.0 software. RESULTS AND CONCLUSION: Thirty-four randomized controlled trials were included, involving seven interventions, such as single acupuncture treatment, single western medicine treatment, single Chinese medicine treatment, acupuncture plus western medicine combination therapy, acupuncture plus Chinese medicine combination therapy, Chinese medicine + western medicine treatment, acupuncture + Chinese medicine + western medicine combined treatment. (1) In the treatment efficiency, acupuncture combined with traditional Chinese medicine is the best in the treatment of primary osteoporosis, and acupuncture combined with traditional Chinese medicine, acupuncture combined with western medicine and acupuncture combined with traditional Chinese medicine western medicine were significantly better than traditional Chinese medicine combined with western medicine (P 0.05). In the included studies, a very small number of patients developed acupuncture and blood stasis after acupuncture, but no fainting or unreported, and no other side effects were found. To conclude, acupuncture combined with other therapies can improve the efficiency, increase the bone mineral density and alleviate pain.
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BACKGROUND: In recent years, some scholars have proposed the use of medial femoral neck support plate combined with cannulated screw internal fixation to treat Pauwels type III femoral neck fracture. This method can reduce the incidence of complications such as nonunion of the femoral neck fracture and femoral head necrosis. However, it is still controversial whether this treatment can accelerate fracture healing and reduce femoral head necrosis in clinic. OBJECTIVE: Meta-analysis was performed to evaluate the difference in the efficacy of femoral medial support plate combined with cannulated screw internal fixation and simple cannulated screw internal fixation for the treatment of Pauwels type III femoral neck fracture. METHODS: Cochrane Library, PubMed, Wanfang Medical Network, China National Knowledge Infrastructure, and China Journal Full-text Database were used to search for and collect the clinical Chinese and English literature of the trials regarding Pauwels III femoral neck fracture treated with internal femoral support plate combined with cannulated screw internal fixation and simple cannulated screw internal fixation. Two evaluators independently conducted quality evaluation, data extraction and cross-checking of the included studies, and finally performed meta-analysis on the collected data using RevMan 5.3 software. RESULTS AND CONCLUSION: (1) After screening, 5 related clinical trials were included, including 4 randomized controlled trials and 1 retrospective cohort study, for a total of 243 patients with Pauwels III femoral neck fracture. (2) Meta-analysis results showed that compared with simple cannulated internal fixation, operation time was longer [MD=23.19, 95%C/(8.32, 38.06), P=0.002], intraoperative blood loss was more [MD=83.48, 95%C/(32.08, 134.89), P=0.001], and healing time was shorter [MD=-1.56, 95%C/(-1.89, -1.24), P < 0.000 01], the incidence of complications was lower [RD=-0.07, 95%C/(-0.11, -0.02), P=0.003], and hip Harris score was higher [MD=7.39, 95%C/(3.18, 60), P=0.000 6] in the femoral medial support plate combined with cannulated screw internal fixation. However, there was no statistically significant difference in the excellent and good rate of hip function between the two treatments [OR=1.29, 95%C/(0.02, 74.86), P=0.90]. (3) In the treatment of Pauwels type III femoral neck fracture, compared with simple cannulated nail fixation, cannulated screws combined with medial support plate can shorten healing time, reduce postoperative complications and elevate postoperative Harris score.
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@#Indocyanine green (ICG) is a fluorescence indicator characterized by low trauma, a long effect time, low cytotoxicity, and high imaging resolution. It has been widely used in biomedical applications. However, ICG is not widely used in the treatment of oral cancer. This article reviews the application of ICG in the diagnosis and treatment of oral cancer. The results of a literature review showed that in the diagnosis and treatment of oral cancer, ICG mainly plays a role through the enhanced permeability and retention (EPR) effect of fluorescent substances and in coupling with various tumor-specific antibodies. For tumor visualization, ICG can focus on the primary tumor and lymph node metastasis by coupling the specific tumor antibodies and the EPR effect to guide the complete resection of the primary tumor and the determination of neck lymphadenectomy. In the reconstruction of the oral, head and neck regions, semi-quantitative measurement of ICG fluorescence intensity can be used to design a guide for a vascularized flap during the operation, for early detection of flap crisis after the operation, and to guide clinical flap exploration opportunities. In nonsurgical treatments of oral cancer, such as photothermal therapy and photodynamic therapy, ICG, as an important component of photosensitive nanomaterials, has attracted the attention of many scholars. ICG has good application prospects in the resection, reconstruction, visualization and nonsurgical treatment of oral cancer.
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@#AIM: To observe the effects of Qi Jing Mingmu decoction combined with artificial tears on the clinical results and cell aging of conjunctivochalasis. <p>METHODS: Forty cases(80 eyes)of grade II-Ⅳ CCH with liver-kidney Yin deficiency were randomly divided into two groups: combined treatment group and artificial tears group, which were treated with Qi Jing Mingmu decoction combined with artificial tears and simple artificial tears respectively. The international ocular surface disease index(OSDI), tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were observed and the clinical effects were compared after 3mo treatment. For CCH patients with grade III or above, followed up for 3mo or more and willing to operate, the loose conjunctival tissue was removed and the cell aging related β-gal staining was performed on frozen sections. The results were statistically analyzed. <p>RESULTS: The OSDI score(14.53±2.68), BUT 9.25±3.02s and SⅠt(8.95±3.57mm/5min)of combined treatment group were significantly better than those of artificial tears group after 3mo treatment(all <i>P</i><0.05). After drug treatment, 7 cases(7 eyes)in artificial tears group and 4 cases(4 eyes)in combined treatment group of CCH patients were treated by operation. The positive rate of aging cells in combined treatment group was significantly lower than that in artificial tears group(16.00±7.84 <i>vs </i>39.00±14.09, <i>P</i>=0.013).<p>CONCLUSION: Qi Jing Mingmu decoction combined with artificial tears to treat CCH is more effective than simple artificial tears in relieving ocular symptoms, improving tear film and promoting tear secretion. Combined treatment can also reduce the cell aging in CCH, which can be used as a safe and effective treatment method in addition to surgical operation.
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@#AIM: To observe the effects of Qi Jing Mingmu decoction combined with artificial tears on the clinical results and cell aging of conjunctivochalasis. <p>METHODS: Forty cases(80 eyes)of grade II-Ⅳ CCH with liver-kidney Yin deficiency were randomly divided into two groups: combined treatment group and artificial tears group, which were treated with Qi Jing Mingmu decoction combined with artificial tears and simple artificial tears respectively. The international ocular surface disease index(OSDI), tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were observed and the clinical effects were compared after 3mo treatment. For CCH patients with grade III or above, followed up for 3mo or more and willing to operate, the loose conjunctival tissue was removed and the cell aging related β-gal staining was performed on frozen sections. The results were statistically analyzed. <p>RESULTS: The OSDI score(14.53±2.68), BUT 9.25±3.02s and SⅠt(8.95±3.57mm/5min)of combined treatment group were significantly better than those of artificial tears group after 3mo treatment(all <i>P</i><0.05). After drug treatment, 7 cases(7 eyes)in artificial tears group and 4 cases(4 eyes)in combined treatment group of CCH patients were treated by operation. The positive rate of aging cells in combined treatment group was significantly lower than that in artificial tears group(16.00±7.84 <i>vs </i>39.00±14.09, <i>P</i>=0.013).<p>CONCLUSION: Qi Jing Mingmu decoction combined with artificial tears to treat CCH is more effective than simple artificial tears in relieving ocular symptoms, improving tear film and promoting tear secretion. Combined treatment can also reduce the cell aging in CCH, which can be used as a safe and effective treatment method in addition to surgical operation.
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Abstract Objective To evaluate the factors associated with the need for insulin as a complementary treatment to metformin in pregnant women with gestational diabetes mellitus (GDM). Methods A case-control study was performed from April 2011 to February 2016 with pregnant women with GDM who needed complementary treatments besides diet and physical exercise. Those treated with metformin were compared with those who, in addition to metformin, also needed the combination with insulin. Maternal characteristics and glycemic control were evaluated. Multinomial logistic regression models were developed to evaluate the influence of different therapies on neonatal outcomes. Results A total of 475 pregnant women who needed pharmacological therapy were evaluated. Of these, 366 (77.05%) were submitted to single therapy with metformin, and 109 (22.94%) needed insulin as a complementary treatment. In the analysis of the odds ratio (OR), fasting glucose (FG)<90 mg/dL reduced the odds of needing the combination (OR: 0.438 [0.235-0.815]; p=0.009], as well as primiparity (OR: 0.280 [0.111-0.704]; p=0.007]. In obese pregnant women, an increased chance of needing the combination was observed (OR: 2,072 [1,063-4,039]; p=0,032). Conclusion Obesity resulted in an increased chance of the mother needing insulin as a complementary treatment to metformin, while FG<90 mg/dL and primiparity were protective factors.
Resumo Objetivo Avaliar os fatores associados à necessidade de insulina como tratamento complementar à metformina em gestantes com diabetes mellitus gestacional (DMG). Métodos Um estudo caso-controle foi realizado de abril de 2011 a fevereiro de 2016 comgestantes portadoras de DMG que necessitaram de tratamentos complementares além de dieta e exercícios físicos. Aquelas tratadas commetformina foram comparadas com aquelas que, além da metformina, também precisaram de combinação com insulina. Foram avaliadas as características maternas e de controle glicêmico. Modelos de regressão logística multinomial foram construídos para avaliar a influência das diferentes terapias nos desfechos neonatais. Resultados Foram avaliadas 475 gestantes que necessitaram de terapia farmacológica. Destas, 366 (77,05%) utilizaram terapia única com metformina, e 109 (22,95%) necessitaram de insulina como tratamento complementar. Na análise da razão de possibilidades (RP), a glicemia de jejum (GJ)<90mg/dL reduziu as chances de necessidade da combinação (RP: 0,438 [0,235-0,815]; p=0,009), bem como a primiparidade (RP: 0,280 [0,111-0,704]; p=0,007). Em gestantes obesas, foi observada uma chance maior de necessidade da combinação (RP: 2.072 [1.063-4.039]; p=0,032). Conclusão A obesidade resultou em um aumento na chance de a mãe precisar de insulina como tratamento complementar à metformina, enquanto a GJ<90 mg/dL e a primiparidade foram fatores de proteção.
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Humans , Female , Pregnancy , Adult , Diabetes, Gestational/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Metformin/therapeutic use , Parity , Blood Glucose/metabolism , Case-Control Studies , Diabetes, Gestational/diet therapy , Diabetes, Gestational/blood , Drug Therapy, Combination , Exercise Therapy , Obesity, Maternal/complications , Obesity, Maternal/diet therapy , Obesity, Maternal/bloodABSTRACT
Although the combination of surgery, radiotherapy and chemotherapy is the main methods of cancer treatment, it still fails to solve certain tumors, especially metastatic tumors. With the in-depth study of tumorigenesis and development mechanism, and the exploration and clinical application of tumor immunotherapy, the survival period of patients with malignant tumors has been significantly prolonged. Tumor immunotherapy has become an effective anti-tumor method by activating the body′s own immune system to achieve tumor suppression. The combination of chemotherapy and immunotherapy has a significant effect and has become a feasible solution for cancer treatment. The rationally designed nanomedicines can effectively combine chemical drugs and immunological preparations, and have become an effective delivery carrier basis and treatment means for clinically targeting tumor tissues, synergistic immune mechanisms to kill tumor cells, and treating tumors. In this paper, the types of multifunctional nanomedicines used in chemotherapy and various immunotherapies in recent years and their advantages in cancer therapy were reviewed.
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Objective@#To investigate the inhibitory effect of AKR1B10 inhibitor combined with sorafenib on hepatocellular carcinoma (HCC) xenograft growth.@*Methods@#HepG2 xenograft model was established in nude mice. The mice were then randomly divided into four groups: control group, epalrestat monotherapy group, sorafenib monotherapy group and combination treatment group. Tumor volume, tumor weight, T/C ratio and the change in body weight of nude mice in each group were compared to evaluate the curative effect. Immunohistochemistry staining was used to detect the expression of Ki-67 in tumor tissues to evaluate the proliferation status of tumor cells. One-way analysis of variance was used to compare the differences between the groups. Student’s t-test was used to test means of two groups and chi-square test was used for multiple samples.@*Results@#The differences of the grafted tumor volume before and after treatment between the control group, epalrestat group, sorafenib group and combined therapy group was 238.940 ± 39.813, 124.991 ± 84.670, -26.111 ± 11.518, and -54.072 ± 17.673(mm3), respectively, (F = 37.048, P < 0.001). The tumor mass were 0.273 ± 0.140, 0.158 ± 0.078, 0.079 ± 0.054, 0.045 ± 0.024 (g), (F = 16.594, P < 0.001); T/C ratio were 100%, 57.9%, 28.9%, 16.5%, and Ki-67 positive rate were 23.295 ± 6.218, 13.503 ± 3.392, 7.325 ± 2.257, 4.664 ± 1.189 (%), (χ2 = 822.203, P < 0.001) . The tumor volume (t = -3.579, P = 0.002) and Ki-67 positive rate (t = -10.003, P < 0.001) in epalrestat monotherapy group were significantly lower than control group. The tumor volume (t = 2.056, P = 0.025), tumor mass (t = 2.101, P = 0.043), and Ki-67 positive rate (t = -2.850, P = 0.005) in combination treatment group were significantly lower than sorafenib monotherapy group. Compared with the control group, the body weight of nude mice in the treatment group decreased to a certain extent, but there was no statistically significant difference between epalrestat monotherapy group and control group (t = -1.599, P = 0.262), and combined therapy and sorafenib monotherapy group (t = -0.051, P = 0.96).@*Conclusion@#AKR1B10 inhibitor enhanced the inhibitory effect of sorafenib on hepatocellular carcinoma xenograft.
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Objective Both triptolide and pulsed radiofrequency can effectively alleviate neuropathic pain (NP). This study aims to investigate the effects of combined treatment with triptolide and pulsed radiofrequency on Wnt/β-catenin signaling pathway and inflammatory factors by establishing a spinal nerve ligation (SNL) rat NP model, thus providing a new idea for NP therapy. Methods A rat NP model of SNL was established, and sham surgery group, model group, triptolide group, pulsed radio frequency group and combined treatment group were set up. The mechanical withdrawal threshold (MWT) of rats in each group was measured at preoperative (Day 1) and postoperative (Days 1, 3, 5, 7 and 14) time points. Spinal dorsal root ganglion was collected 3, 7 and 14 days after the surgery, and mRNA expression levels of Wnt-3α and β-catenin were detected by RT-PCR, protein expression levels of iNOS and COX-2 by Western blot, and relative expression levels of GAP-43 by immunohistochemical staining. Results The MWT of the model group, triptolide group and pulsed radiofrequency group (7.38±0.08, 9.31±0.23, 8.46±0.30) were lower than that of the combined treatment group (11.65±0.19), with a statistically significant difference (P<0.05). The relative expression levels of Wnt-3α, β-catenin, iNOS mRNA and COX-2 mRNA after the combined treatment were significantly lower than those of the model group, triptolide group and pulsed radiofrequency group (P<0.05). The relative expression levels of GAP-43 after the combined treatment (1.23±0.02) was significantly higher than that of the model group, triptolide group and pulsed radiofrequency group (1.01±0.02, 0.94±0.03, 0.79±0.01), with a statistically significant difference (P<0.05). Conclusion The effects of the combined treatment is significantly better than that of triptolide and pulsed radiofrequency alone, as the combination has a stronger relieving effect on nerve inflammation and promotes the regeneration of nerve cells.
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Bullous pemphigoid is a chronic obstinate dermatological disease. Hormone is the main therapeutic method, but the disease course is rather long, relapse is frequently seen and difficult to be radically cured; many complications may occur such as pulmonary infection, etc. From traditional Chinese medicine (TCM) basic principal points of view "lung governing skin and hair" and "strengthen the body resistance to eliminate pathogenic factors", the author explored the TCM therapy of bullous pemphigoid. By using clearing away lung heat and invigorating lung qi as the main principles supplemented by invigorating spleen and kidney, eliminating phlegm and blood stasis for treatment of such disease, relatively satisfactory therapeutic results were obtained.
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Although the combination of surgery, radiotherapy and chemotherapy is the main methods of cancer treatment, it still fails to solve certain tumors, especially metastatic tumors. With the in-depth study of tumorigenesis and development mechanism, and the exploration and clinical application of tumor immunotherapy, the survival period of patients with malignant tumors has been significantly prolonged. Tumor immunotherapy has become an effective anti-tumor method by activating the body's own immune system to achieve tumor suppression. The combination of chemotherapy and immunotherapy has a significant effect and has become a feasible solution for cancer treatment. The rationally designed nanomedicines can effectively combine chemical drugs and immunological preparations, and have become an effective delivery carrier basis and treatment means for clinically targeting tumor tissues, synergistic immune mechanisms to kill tumor cells, and treating tumors. In this paper, the types of multifunctional nanomedicines used in chemotherapy and various immunotherapies in recent years and their advantages in cancer therapy were reviewed.
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@#AIM: To investigate the efficacy and clinical outcomes of combined treatment for fungal corneal ulcer in Western China.<p>METHODS: Totally 85 cases(85 eyes)of fungal corneal ulcer diagnosed in our hospital from November 2017 to February 2018 were determined according to the severity of the disease. Took 11 comprehensive measures to treat, they were treated with corresponding drugs and combined operation respectively, all patients were followed up for 6-8mo to observe corneal ulcer healing and final disease outcomes.<p>RESULTS: The average length of hospital stay for fungal corneal ulcer was 12d, and 79 eyes were cured in 85 eyes. The cure rate was 93%, 5 eyes improved(6%), and 1 eye was invalid(1%).<p>CONCLUSION: Systemic and local drug therapy for fungal corneal ulcer, the operation was performed by corneal debridement, iodine cautery, conjunctival flap covering, amniotic membrane transplantation and keratoplasty, which will receive ideal therapeutic effects and restore vision.
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OBJECTIVE: To observe the clinical efficacy of joint application of electroacupuncture (EA), acupointinjection and fire-needle in the treatment of menopausal syndrome (MS) women. METHODS: One hundred MS patients were randomized into control group and combined treatment group (n=50 patients in each). The combined treatment group was treated by joint application of EA, acupoint-injection and fire-needle stimulation, and the control group treated by EA stimulation alone. EA was applied to Shenshu (BL 23), Xinshu (BL15), Taixi (KI 3), Sanyinjiao (SP 6), Laogong (PC 8), Pishu (BL 20), etc., for 30 min, once daily for 10 days. Point-injection of red ginseng-ophiopogon root injection (0.5 mL) or red-hot needle stimulation was applied to bilateral BL15, BL 20, SP 6 and BL 23 once daily for 10 days and once every other day for 5 times, respectively. The modified Kupperman index scale was used to evaluate symptoms (hot flashes and night sweats: 4 points; paresthesia, insomnia, dyspareunia, irritability and problems of urinary system: 2 point each; depression, dizziness, fatigue, joint pain or muscular pain, headache, palpitation, skin formication: 1 point each) of the perimenopausal syndrome, and 3 months' follow-up survey was conducted after the treatment. Each symptom score was calculated as the product of the symptom severity score (0, no; 1, mild; 2, moderate; 3, severe) multiplied by the points of symptom index. The total Kupperman score was the sum of the scores of all the items. The therapeutic effect was also evaluated according to the "Guiding Principles for Clinical Trials of New Drugs of Chinese Materia Medica" (2002). RESULTS: The Kupperman scores were significantly decreased following the 10 days' treatment and 3 months thereafter in both control and combined treatment groups in comparison with their individual pretreatment (P<0.05), and were obviously lower in the combined treatment group than in the control group after treatment (P<0.05). Of the both 50 patients in the control and combined treatment groups, 22(44%) and 35 (70%) experienced a remarkably improvement, 18(36%) and 12(24%) were effective, and 10(20%) and 3 (6%) ineffective, with the total effective rates being 80% and 94%, respectively. The therapeutic effect of the combined treatment group was notably superior to that of the control group (P<0.05). CONCLUSION: The joint application of electroacupuncture (EA), acupoint-injection and fire needle is significantly superior to that of simple EA in improving the symptoms of patients with menopausal syndrome.