RESUMEN
ObjectiveIn the treatment of acute gouty arthritis （AGA）， western medicine is mostly used for anti-inflammatory and analgesic purposes to control the blood uric acid level， but some patients are still at risk of poor control and recurrent attacks. Chinese medicinal prescriptions， potent in resisting inflammation and relieving pain， are able to stabilize the blood uric acid level， reduce acute attacks， and improve the clinical efficacy of western medicine. However， there is a lack of evidence to support their use as evidence-based medicine. This study employed network Meta-analysis （NMA） to evaluate the efficacy and safety of common Chinese medicinal prescriptions in the treatment of AGA， aiming to provide evidence-based medical evidence for the clinical use of Chinese medicinal prescriptions in the treatment of AGA. MethodChinese and English databases were searched for prospective cohort studies and randomized controlled trials （RCTs） on Chinese medicinal prescriptions against AGA from database inception to December 1， 2022. Stata software and Review Manager were used for statistical analysis. ResultForty-four papers with 3 564 cases involved were included in the current NMA. In terms of reducing blood uric acid， the cumulative probability results showed that Mahuang Lianyao Chixiaodou Tang showed optimal efficacy （87.60%）. In terms of relieving joint pain， Danggui Niantongtang and Guizhi Shaoyao Zhimutang showed optimal efficacy （92.00% and 82.30%）. In terms of improving erythrocyte sedimentation rate （ESR）， Simiaowan was superior to other prescriptions （87.00%）. In terms of reducing C-reactive protein （CRP）， Simiaowan and Baihutang modified with Guizhitang showed superior efficacy （76.00% and 66.10%）. In terms of safety， except for the basic treatment group， Mahuang Lianyao Chixiaodou Tang had the lowest probability of adverse events， and Danggui Niantongtang had the highest probability of adverse reactions during treatment. According to the results of cluster analysis， Mahuang Lianyao Chixiaodou Tang and Simiaowan are effective and safe. ConclusionAccording to the results of NMA， Chinese medicinal prescriptions can assist in the treatment of AGA and improve the effectiveness of western medicine. For patients with AGA， clinicians can choose Mahuang Lianyao Chixiaodou Tang or Simiaowan as an auxiliary drug for routine western medicine treatment.
RESUMEN
OBJECTIVE：To prom ote the implementation of clinical comprehensive evaluation of drugs in China ，promote the return of drugs to clinical value ，improve the utilization efficiency of limited resources ，and provide reference for decision makers of health departments. METHODS ：By combing the relevant policy documents and literatures of clinical comprehensive evaluation of drugs，the evolution and research progress of relevant policies in China were introduced ；the advanced experiences （including evaluation subjects ，evaluation value dimensions ，evaluation methods ，evaluation procedures and results applications ）of Canada ，the United States ，the United Kingdom ，Australia，Europe，International Society for Pharmacoeconomics and Outcomes Research and other countries （regions/organizations）were analyzed and summarized ；relevant suggestions on the construction of China ’s clinical comprehensive evaluation mechanism for drugs were put forward. RESULTS & CONCLUSIONS ：It is suggested that the following measures should be taken to construct the clinical comprehensive evaluation mechanism of drugs in China including that the development goal and orientation of clinical comprehensive evaluation of drugs should be further clarified with the guidance of decision-making needs ；the government should play a leading role and strengthen inter departmental cooperation and policy coordination；the traceability quality control system of internal and external standards should be established ，adhere to openness ， fairness and fair ；at the same time ，it is suggested to give full play to the role of informatization and big data ，strengthen the exploration of evaluation methodology and standards ，strengthen the transformation and application of evaluation results ，and promote the service of evaluation results to policy decision-making.
RESUMEN
Objective To compare the prognostic value of simplified revised Geneva Prognostic Score (sGPS), Pulmonary Embolism Severity Index (PESI) and simplified Pulmonary Embolism Severity Index (sPESI) in patients with acute pulmonary thromboembolism(PTE). Methods A retrospective cohort study was carried out on 276 consecutive patients with identified acute PTE admitted to our hospital from January 1997 to December 2016. We dichotomized patients as low vs. high risk in all three scoring systems. The 30-day mortality of the patients were used as prognostic factors. The prognostic value of each scoring system was evaluated by the area under the receiver operating characteristic curve(ROC). Results (1) The overall 30-day mortality of 276 patients with acute PTE was 22.5％. The 30-day mortality of patients in low vs. high risk groups according to sGPS, PESI and sPESI were 7.6％vs. 47.1％, 1.0％ vs. 34.3％, 2.4％ vs. 30.9％, respectively. The 30-day mortality of patients in high risk groups according to sGPS, PESI and sPESI were significantly higher than those of patients in low risk groups(P<0.01). The 30-day mortality of patients in low risk groups according to sGPS and PESI were significantly different(P=0.020). The 30-day mortality of patients in high risk groups according to sGPS were significantly different from those of patients in high risk groups according to PESI and sPESI, respectively (P=0.033, P=0.006). (2) The areas under the receiver operating characteristic (ROC) curves for evaluating the prognosis of patients with acute PTE according to sGPS, PESI and sPESI were 0.824, 0.891 and 0.846, respectively. The specificity (84.6％), the accuracy (84.4％) and the positive predictive value (61.2％) of PESI were the highest among the three prediction rules, the sensitivity (83.9％) and the negative predictive value (94.8％) of PESI were also relatively high. The negative predictive value of sPESI (98.6％) was the highest among the three prediction rules. Conclusions PESI can be more accurate for the overall risk stratification of patients with acute PTE, while sPESI is more helpful for identifying those patients with acute PTE who can be discharged early.
RESUMEN
Objective To study the effects of supplemental Dangguibeimukushen pill prescription on the expressions of MMP13 and bFGF in tumor tissues on H22 hepatoma bearing mice.Methods H22 hepatoma bearing mice was employed to carry out anti-tumor experiment in vivo in this study.A total of 60 mice were randomly divided into model group,DDP positive control group,low and high dosage of supplemental Dangguibeimukushen pill treatment group,supplemental Dangguibeimukushen pill combined with DDP group.In each gruop,gastric infusion was performed continuously 14 d.The tumor growth and the general conditions of mice were recorded.After the last administration of gavages orally treatment,all mice were anaesthetized and killed by cervical disloca-tion method to obtain completely tumor tissue for further HE staining measure and detection of MMP13 and bFGF in tumor tissue with the method of RT-qPCR and immunohistochemistry.Results The tumor volume of model group and low dosage of supple-mental Dangguibeimukushen pill treatment group were larger than that of other groups,futhermore,ulceration were found inside tumor,and basic integrity were observed of tumor capsule.However,in all the treatment groups,the tumor volume was relatively smaller,and the capsule of tumor was incomplete,ulceration of different degrees and bleeding when tumor was peeled off.In combi-nation groups,the tumor volume was much smaller,and the tumor had incomplete capsule and less ulceration inside.Pathological observation showed that connective tissue was found inside tumor,cells were sparsely spread and the number of necrosis cancer cells were increased in all treatment groups.RT-qPCR detection showed that the mRNA expression of MMP13 and bFGF in each treat-ment group were decreased comparing with the model group,and the difference was statistically significant(P <0.05).Immunohis-tochemical detection showed that the expression of MMP13 and bFGF in the combined group were less colored and weakly positive expression comparing with the positive group or the pure Chinese medicine treatment group,the difference was statistically signifi-cant(P <0.05).Conclusion Dangguibeimukushen pill could downregulate the expression of MMP13 and bFGF of tumor tissue in H22 hepatocarcinoma xenograft mice at mRNA and protein levels,and played a vital role in inhibiting cancer invasion and angiogen-esis,reducing toxics and side effects and enchancing its efficiency.
RESUMEN
Objective To compare the pharmacokinetics difference of methotrexate ( MTX) alone or MTX combined with the decoction of Radix Salviae Miltiorrhizae ( RSM) in rats, and to investigate the possible impact of RSM on the efficacy and pharmacokinetics of MTX after oral administration. Methods Sprague-Dawley rats were given MTX (7 mg/kg) alone or MTX together with RSM (3.085 g/kg) respectively. At different time points, blood was sampled from orbital venous plexus and then was precipitated by perchloric acid. The serum concentration of MTX was determined by using high performance liquid chromatography ( HPLC) method. Chromatographic separation was achieved on a reversed-phase Diamonsil C18 (2) column with the mobile phase of methanol-formic acid water solution (formic acid in volume fraction of 0.1%) in gradient elution. The column temperature was 27 ℃, flow rate was 1 mL/min, detection wavelength was 302 nm, and the injection volume was 10 μL. The results were analyzed by pharmacokinetic software DAS ( 2.1.1) by non-compartment model. Results The linearity of the calibration curve for MTX was good in the range of 0.097 6 ~ 12.5 mg/L, the detection limit was 0.097 6 mg/L and the recovery was in the range of 77.5% ~ 86.6%. Compared with MTX group, the peak-arriving time of MTX-RSM group was advanced, and the clearance of MTX was delayed. Area under concentration-time curve at 0-t (AUC(0-t)) was increased by 0.609 times, and AUC(0-∞) was increased by 0.786 times. Conclusion The decoction of RSM exerts an effect on promoting the absorption of MTX, delaying the clearance of MTX and enhancing the bioavailability of MTX in vivo.
RESUMEN
Fifty outpatients of newly diagnosed hypertension (NDH,with course of disease ≤ 3 months) and 50 patients with routinely revisit hypertension (RRH,with course of disease ≥ 1 year) were consecutively enrolled respectively from February 2010 to July 2010.They were asked to complete the Beck Depression Inventory (BDI),Spielberger State-Trait Anxiety Inventory (STAI) and the SF-36 questionnaire.The results showed that compared with the RRH group,the NDH group were more worried about being diagnosed as hypertension,dependence and side effects of antihypertensive drugs and complications of hypertension (all P ＜ 0.05).The NDH group displayed significantly higher level of anxiety compared with that of the RRH group (P ＜ 0.001).No significant differences were found in depression and 8 dimensions of SF-36 forms between two groups (P ＞ 0.05).The results indicated that patients of NDH have significant higher level of anxiety than that of RRH,they should be given more psychological intervention and appropriate health education.
RESUMEN
Objective To analyze current status of research on pulmonary embolism and changes of its knowledge in domestic academic literatures.Methods Totally,2319 domestic papers on pulmonary embolism were collected by computerized retrieval from CHKD system during the period of 1994 to 2006 with a key word of"pulmonary embolism",and were classified and summarized according to their type,contents,author's affiliation.Results Number of papers on pulmonary embolism increased quickly in recent 13 years,especially in the last five years,from 25 papers in 1994 to 430 in 2006.Most of the papers in the early stage were case reports,and the number and proportion of original articles increased obviously after 1997.Contents of the papers were mainly about clinical manifestation and examinations of pulmonary embolism,but papers on its auxiliary examinations,laboratory examinations,clinical nursing care,animal experiments,and so on were all increased.Authors of the papers were from varied departments of hospitals,mainly in the department of internal medicine,especially in the departments of cardiology and respiratory diseases,followed by the divisions of medical imaging,radiation and nuclear medicine.Papers were mainly submitted by authors from affiliated hospitals of medical schools and hospitals at city-level,and papers submitted by gross-roots hospitals such as county hospital and clinic also increased.Conclusion Significant success in diagnosis and treatment of pulmonary embolism has been achieved domestically in recent 13 years,which has been recognized popularly by Chinese physicians.
RESUMEN
The catalytic domain of KDR kinase (KDR-CD) was amplified from RNA of HUVCEs cells with RT-PCR and expressed in E. coli BL21(DE3) by plasmid pET30a as vector. The recombinant protein was purified with affinity chromatography (Ni-NTA). Western blotting showed that the recombinant KDR-CD was phosphorylated in E. coli BL21(DE3). The recombinant KDR-CD was identified to have kinase activity catalyzing the substrate phosphorylated with ATP in the enzymatic reaction.
Asunto(s)
Humanos , Dominio Catalítico , Genética , Clonación Molecular , Células Endoteliales , Biología Celular , Escherichia coli , Genética , Metabolismo , Vectores Genéticos , Proteínas Recombinantes , Genética , Venas Umbilicales , Biología Celular , Receptor 2 de Factores de Crecimiento Endotelial Vascular , GenéticaRESUMEN
Objective To investigate the causes and treatment of recurrent laryngeal nerve (RLN) injury during the operation of thyroidectomy. MethodsClinical data of 48 patients that RLN were injured during thyroidectomy in and out of our hospital from Jun. 2003 to Mar. 2007 were reviewed. ResultsNo patient died while operation and staying in hospital. There were 47 cases of unilateral RLN injury, 1 case of bilateral RLN injury; 21 cases (43.7%) were injured because of suture or scar adhesion, 13 cases (27.1%) were partly broken with formed scar, 14 cases (29.2%) were completely cut off; The locations of RLN injuries were closely adjacent to the crossing of the inferior thyroid artery and RLN in 13 cases (27.1%) and 35 cases (72.9%) were within 2 cm below the point of RLN entering into throat. The injured RLN were repaired surgically in 43 cases, among which 39 cases’ phonation and vocal cord movement were restored completely or had their vocal cord movement recovered partly; There were only 4 cases that the phonation and vocal cord movement were not recovered. Another 5 cases that did not take any repair did not recovered naturally. ConclusionThe location of most RLN injuries caused by mechanical injury during thyroid surgery is closely adjacent to the entrance of RLN into throat. Early nerve exploratory operation should be performed once the RLN is injured, and the method of repair should be decided according to concrete conditions of injury.
RESUMEN
Objective To investigate the diagnostic status of pulmonary thromboembolism (PTE) for inpatients in Peking Union hospital Methods Inpatients diagnosed acute PTE from January 1999 to December 2002 were reviewed and divided by sex, age and risk factors Results Among 78 844 inpatients, 155 were diagnosed PTE during 4 year period, 73 of 27 100 in men (0 27%) vs 82 of 51 744(0 16%)in women, and 52 of 17 459 (0 30% ) in elderly patients(≥60 years) vs 103 of 61 385 (0 17% ) in non elderly patients(
RESUMEN
1 cm or tumor penetrating through the thyroid capsule(P1 cm or tumor penetrate through the thyroid capsule.
RESUMEN
Objective To study the choice of initial operative approach for thyroid nodule and the necessity of reoperation after local excision of differentiated thyroid cancer.Methods Clinical data of 138 patients with differentiated thyroid cancer after local tumor excision had reoperation at our hospital during a period of four year were retrospectively reviewed.All the reoperations were bilateral thyroidectomy and cervical lymph node excision.Results There were 76.8% patients with residual cancer in thyroid and cervical lymph node.There were 23 patients(16.7%) with recurrent laryngeal nerve injury that included 22 cases with unilateral and 1 case with bilateral injury after the initial operation,and 19 of the 23 patients with recurrent laryngeal nerve injury recovered after nerve repair.After thyroid reoperation,3 cases(2.2%) had recurrent laryngeal nerve injury,2 cases(1.4%) had partial parathyroid gland injury,2 cases(1.4%) had superior laryngeal nerve injury,but there were no cases of esophageal injury or postoperative bleeding.Conclusions The incidence of residual cancer is high after local excision for differentiated thyroid cancer,therefore,reoperation with bilateral thyroidectomy and cervical lymph node excision is necessary.