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Bronchial asthma is a chronic respiratory disease，characterized by airway inflammation，airway hyperresponsiveness，reversible airway obstruction and airway remodeling，in which a variety of cells including airway inflammatory cells and structural cells are involved. Previous studies have shown that asthma is mainly driven by Th2 cytokines IL-4，IL-5，and IL-13，leading to airway eosinophil inflammation. With further research，however，it has been found that neutrophils are also closely related to asthma. Numbers of neutrophils are elevated in airway through increased chemotaxis and decreased apoptosis，which is earlier than eosinophils，leading to airway neutrophilic inflammation. Neutrophils can produce elastase，myeloperoxidase，neutrophil extra- cellular traps，chemokines and cytokines，participating in the occurrence and development of asthma. The antagonists against these molecules，such as anti-IL-8 receptor antibody，anti-IL-17 antibody，and DNase，have shown positive effects on neutrophilic asthma，but further studies are needed to support their clinical application. This article mainly reviews the role of neutrophils in asthma and related mechanisms.
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Humans , Asthma/immunology , Cytokines , Eosinophils , Inflammation , Neutrophils/immunologyABSTRACT
INTRODUÇÃO: O câncer de mama é o câncer mais prevalente entre as mulheres em todo o mundo. Semelhante à quimioterapia, o tratamento antineoplásico está associado a muitos efeitos colaterais, sendo o cansaço um dos mais comuns. É importante investigar possíveis tratamentos, especialmente alternativas não farmacológicas, para controlar os sintomas que afetam diretamente a qualidade de vida das mulheres. OBJETIVO: O objetivo deste estudo foi fornecer evidências científicas para verificar à eficácia da acupuntura no manejo da fadiga em pacientes com câncer de mama. MÉTODOS: Este estudo envolveu uma revisão sistemática baseada na metodologia Preferred ReportingItems for Systematic Reviews e MetaAnalysis (PRISMA). Ensaios clínicos randomizados publicados em revistas científicas indexadas foram compilados. A pesquisa bibliográfica foi realizada utilizando as bases de dados eletrônicas, PubMed, PEDro e BIREME, utilizando os descritores "câncer de mama", "fadiga", "acupuntura" e "ensaio randomizado". Os critérios de inclusão incluíram artigos on-line totalmente disponíveis que foram classificados como ensaios clínicos randomizados publicados de 2012 a 2017 em inglês ou português. A elegibilidade dos estudosbaseou-se na estratégia PICO, onde a População representou mulheres com câncer de mama e idade entre 18-65 anos, a Intervenção foi a acupuntura, o Controle compreendeu o uso de medidas de cuidado padrão ou acupuntura "sham" e o desfecho foi o desenvolvimento de fadiga. A escala de qualidade PEDro e o escore definido no WebQualis foram usados para avaliar os artigos e os periódicos. RESULTADOS: No total, 66 artigos foram selecionados, mas apenas quarto preencheram todos os critérios de inclusão, totalizando uma amostra de 620 mulheres. Todos os estudos avaliaram o efeito da acupuntura na fadiga e outros sintomas relacionados ao tratamento do câncer de mama com diferentes durações de tratamento. Três artigos relataram resultados estatisticamente significativos, e todos os artigos descreveram melhora clínica da fadiga após a aplicação da acupuntura. A média do escore da escala PEDro foi 6.25. Todos os artigos foram publicados em periódicos estrangeiros e o Web Qualis variou de B2 to A1. CONCLUSÃO: Evidências científicas confirmam a eficácia da acupuntura no manejo da fadiga relatada por mulheres com câncer de mama. A acupuntura foi eficaz na redução da fadiga nos estudos selecionados para esta revisão.
INTRODUCTION: Breast cancer is the most prevalent cancer among women worldwide. Similar to chemotherapy, antineoplastic treatment is associated with many side effects, with fatigue being one of the most common. It is important to investigate potential treatments, especially non pharmacological alternatives, to control symptoms that directly affect women's quality of life. OBJECTIVE: The objective of this study was to provide scientific evidence to verify the efficacy of acupuncture in the management of fatigue in patients with breast cancer. METHODS: This study involved a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. Randomized clinical trials published in indexed scientific journals were compiled. The literature search was performed using the electronic databases, PubMed, PEDro, and BIREME, using the descriptors 'breast cancer', 'fatigue', 'acupuncture', and 'randomized trial'. Inclusion criteria included fully available online articles that were classified as randomised clinical trials published from 2012 to 2017 in either English or Portuguese. Study eligibility was based on the Population, Intervention, Control, Outcome, and Study (PICO) design criteria, in which the (1) population included women 1865 years of age with breast cancer, (2) intervention was acupuncture, (3) comparison referred to standard care or sham acupuncture, and (4) outcome was the evaluation of fatigue. The PEDro scale was applied to evaluate the quality of the studies. WebQualis was also used to evaluate the quality of the journals of the selected articles. RESULTS: In total, 66 articles were selected, but only four fulfilled all inclusion criteria, giving a total sample size of 620 women. All trials evaluated the effect of acupuncture on fatigue and other symptoms related to the treatment of breast cancer with different treatment durations. Three articles reported statistically significant results, and all articles described clinical improvement in fatigue after the application of acupuncture. The average PEDro score of the manuscripts was 6.25. All articles were published in non-Brazilian journals with WebQualis scores that ranged from B2 to A1. CONCLUSION: Scientific evidence confirms the efficacy of acupuncture in the management of fatigue reported by women with breast cancer. Acupuncture was effective in reducing fatigue in the studies selected for this review.
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Acupuncture Therapy , Breast Neoplasms , FatigueABSTRACT
@#Lower extremities motor dysfunction after stroke severely affects the patients' transfer ability and quality of life. This article reviewed the mirror therapy in rehabilitation of lower extremities motor function in stroke patients.
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Introdução: Os conceitos de ocupação e atividade são conceitos centrais para a Terapia Ocupacional, e vêm sendo utilizados diversamente ao longo do tempo, conforme o país, a cultura e o período histórico. Objetivo: O resente estudo tem como objetivo contribuir para o conhecimento do uso dos conceitos de atividade e ocupação na Terapia Ocupacional, na literatura internacional e nacional. Método: Foi realizada uma revisão sistemática de literatura sobre o tema. Resultados: A pesquisa na literatura explorou artigos completos publicados entre 2003 e 2013, totalizando 19 artigos incluídos nesta pesquisa. Os textos relatam a importância de um uso adequado das terminologias na Terapia Ocupacional, como um meio para fortalecer a profissão e promover a coerência nas pesquisas e na prática da Terapia Ocupacional. São descritas algumas das diferenças e semelhanças na utilização dos termos atividade e ocupação na literatura nacional e internacional. Verificou-se que tanto o termo atividade como o termo ocupação se referem a um fazer que é capaz de influenciar os processos de saúde e doença. Conclusão: A conceituação sobre os termos ocupação e atividade estão em processo de construção histórica, e serão necessárias mais pesquisas sobre o assunto para aprofundar o conhecimento sobre o tema
Introduction: The occupation and activity concepts are central for Occupational Therapy, and have been used diversely over time according to the country, culture and historical time. Objective: This study aims at contributing to the knowledge on the use of occupation and activity concepts in Occupational Therapy in the national and international literature. Method: We conducted a systematic literature review on the subject. Results: The literature research explored full articles published between 2003 and 2013, in total 19 articles were included in this study. The texts report the importance of the adequate use of terminologies in occupational therapy as a means to strengthen the profession, and promote the coherence in the Occupational Therapy research and practice. A few differences and similarities in the use of the terms activity and occupation in the national and international literature are described. We noticed that the term activity as the term occupation both refer to a practice that is able to influence the health and illness process. Conclusion: The concepts of occupation and activity are historically developing, and more research about that matter is necessary to deepen the knowledge in this subject.
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Although radical resection is the only method to cure cholangiocarcinoma, most patients are in the advanced stage at the time of diagnosis and miss the best time for surgery. The palliative treatment focusing on biliary drainage reconstruction can improve patients′ quality of life and prolong survival time. This article introduces the latest advances in palliative treatment for cholangiocarcinoma in recent years. Patients can benefit from the treatment methods such as biliary stenting and palliative surgery. Local and systemic adjuvant therapies are also indispensible, such as radiotherapy, chemotherapy, photodynamic therapy, and immunotherapy, but their therapeutic effects await further investigation. With the continuous development of basic research and medical techniques, the traditional therapeutic methods will be constantly improved. The new therapeutic methods targeting the pathogenesis of cholangiocarcinoma will also play an important role and bring benefits to the patients.
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Nucleos(t)ide analogues (NAs) are commonly used as the antiviral treatment in patients with chronic hepatitis B (CHB). The majority of patients need long term medication. Renal injury has been observed in some patients treated with NAs in clinical practice. Therefore, this article reviews the issues regarding renal safety in CHB patients treated with NAs from the following aspects: the possible mechanisms of renal injury, the incidence of renal injury in patients treated with various NAs in recent clinical studies, and the management of renal injury in CHB patients, in order to select the most appropriate drugs for patients.
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Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease, characterized by progressive non-pyogenic inflammation in the small intrahepatic bile ducts, and can cause hepatic fibrosis and liver cirrhosis. The etiology and pathogenesis of PBC remain unknown. The development and progression of PBC are caused by various factors, and the major factor is environmental factors acting on patients with genetic susceptibility. Ursodesoxycholic acid is thought to be the only effective drug, but the complete response rate remains low. This article reviews the diagnosis and treatment of PBC with reference to the literature in the world.
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Hepatocellular carcinoma (HCC) greatly threatens human health. In clinical treatment, the therapeutic strategies for HCC are attracting more attention. With the research advances in the pathogenesis of HCC and the rapid development of molecular biology techniques, the therapies with molecular-targeted antitumor drugs for advanced HCC have become a hot research topic, and significant efficacy has been achieved in clinical practice. This article summarizes the research advances in clinical application of molecular-targeted drugs for the treatment of HCC and related issues, discusses the future perspectives of therapeutic strategies, and provides a new direction and reference for the clinical treatment of HCC.
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@#Postural control dysfunction is one of the key problems in children with cerebral palsy (CP), which interferes with the activities of daily living. Seating is critical for upper extremity movement in children with CP. Compared with their typically developing peers, children with CP in general have the ability to generate direction-specific adjustments, but they show a delayed development in the capacity to recruit direction-specific adjustments in tasks with a mild postural challenge. At present, the treatment approaches of physical therapy mainly included: application of the special sitting system, change of the seat surface inclination and various balance exercise. However, there is limited number of studies on the effect of special training on postural development in children with CP and further researches are needed.
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@#The spasticity can affect the motor function, activities of daily living (ADL), quality of life (QOL) of hemiplegic patients,and also delay the rehabilitation process. Principally, the methods of reducing spasticity included physical therapy and medication at present.The massage technique has been having outstanding effect on alleviating spasticity after stroke. This article reviewed the clinical efficacy,methods and mechanisms of massage treatment for hemiplegic spasticity.
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@#Post-menopause hypertension in female is the appearance of elevation of blood pressure in one year after menopause.It will always bring obesity,blood lipid abnormality,disorders of carbohydrate metabolism,elevation of insulin's leave,elevation of sympathetic nerve's irritability,and so on by the hormone leave and other reason,which has caused wide public concern as one of the reason of coronary heart disease(CHD).The possible pathogenesis of female hypertension is complicated and many factors.These disorders may include decrease of estrogen,overfull pituitrin,putting on weight,composite factors and others unknown neurohumoral factors.During the treatment of high blood pressure,considering the diversity of post-menopause female,it need take concrete illness into account to choose reducing the pressure drug.There are many experiments to approve applied hormone replacement therapy(CRT),but it is still incertitude on post-menopause hypertensive female sufferer.At the same time,hypertension is not the contraindication in application of HRT.It need more advanced stochastic clinical experimentation to prove whether CHD female could benefit from HRT application.
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@#Low molecular weight heparin(LMWH)is a kind of anticoagulant used in both the prevention of clot formation in the blood vessels(thrombosis)and the treatment of conditions caused by clot formation or embolization.They are agents formulated from chemical or enzymatic depolymerization of unfractionated heparin.In the past decade,LMWH has been extensively evaluated in many clinical settings.The applications of LMWH in recent years are reviewed.
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@# As a multipotential stem cell, adipose-derived mesenchymal cell presents similar characters with bone marrow-derived menchymal stem cell in morphology and biology, and has the ability of directional differentiation to the all three germ layers. The adipose-derived mesenchymal stem cell could be harvested conveniently with slighter wound, and has a broad prospect in cell therapy and tissue engineering.
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@#Platelet-derived growth factors (PDGFs) are a member of family of glycoprotein dimers (Mr 27000～35000) that exert potent mitogenic and chemotactic activities toward cells of mesenchymal origin. The PDGFs possess a myriad of critical roles in embryonic development,cellular differentiation and response to tissue damage. It is one of the growth factors,which appear early during the process of wound healing. Especially,PDGFs can effectively promote the healing of some chronic refractory wounds,such as diabetes mellitus ulcer,chronic venous ulcer,bedsore,radioactivity ulcer,etc..
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@#Rehabilitation is very important to the therapeutic effect of total knee arthroplasty, and it's also the key measure for the knee function to reach the expected effect after the surgery. The most important contents of rehabilitation therapies are the training of muscle strength, range of joint motion, joint position sense and gait. Integrated rehabilitation therapies was used to improve the knee function as possible, such as all kinds of training to improve the knee muscle strength of flex and extend; early training of continued positive motion of knee joint to improve the knee range of motion; the training of knee joint position sense to improve the ability of motion control, posture adjusting and balance keeping; the gait training to adjust the unusual gait.
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@#Alzheimer's disease (AD) is a common progressive degenerative disease of the central nervous system. It's also a main cause for dementia in presenium and senectitude. In the past few years, the discoveries in vitro expansion of neural stem cells (NSCs) indicate a new way for recovery and replacement of damaged neurons as well as reconstruction of the neural circuit, and offer a useful future therapy for AD. There are two main promising approaches in NSCs replacement therapy. They are endogenetic approach, inducing proliferation and differentiation of endogenetic NSCs, improving self-repair of central nervous system, and exogenous approach, ransplantation of exogenous tissue and promoting proliferation of endogenous NSCs. However, it may not become truth before the mechanism of NSCs' proliferation, migration, differentiation and it's integration with the host tissues to be elucidated.