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ObjectiveTo systematically review the existing studies on Xueshuantong for injection（lyophilized） in the treatment of acute cerebral infarction（ACI）， and to clarify the clinical value of Xueshuantong for injection（lyophilized） through comprehensive clinical evaluation， so as to promote clinical rational drug use and relevant policy transformation. MethodEvidence of Xueshuantong for injection（lyophilized） in terms of safety， effectiveness， economy， innovation， suitability， accessibility， traditional Chinese medicine（TCM） characteristics（6+1 dimensions） and information service was comprehensively collected. Evidence-based medicine， questionnaire survey， health technology assessment， pharmacoeconomic evaluation and other research methods were used， and the multi-criteria decision analysis model was used to measure each dimension， in order to comprehensively evaluate the clinical value of Xueshuantong for injection（lyophilized）. ResultSpontaneous reporting system， Meta-analysis of adverse reactions， and active safety monitoring study showed that the main adverse reactions of Xueshuantong for injection（lyophilized） were rash， pruritus， chest tightness， headache， dizziness and other general adverse reactions， the incidence of serious adverse reactions was judged to be rare， the known risk was small， the evidence was sufficient， and the safety evaluation was grade A. The results of Meta-analysis showed that Xueshuantong for injection（lyophilized） combined with conventional treatment for ACI was superior to conventional treatment in terms of improving neurological deficit score， improving daily activity score and clinical efficacy， and the effectiveness evaluation was grade B. The results of pharmacoeconomic evaluation showed that Xueshuantong for injection（lyophilized） combined with conventional treatment was relatively economic compared with conventional treatment alone， with the total clinical effective rate as the effect parameter， but the incremental effect was not significant， the economic evaluation was grade B. In addition to ACI and unstable angina of coronary heart disease， the drug also had good clinical efficacy in central retinal vein occlusion， and had a wider range of indications and awarded 16 patents， and its innovation evaluation was grade B. The suitability of medical personnel and patients was good without special technical and management requirements， and the suitability was evaluated as grade B. Xueshuantong for injection（lyophilized） had reasonable price， good affordability， certain prescription restrictions and general availability， the accessibility evaluation was grade B. Since the drug is an injection of effective parts of TCM， no grade evaluation of its TCM characteristics is conducted. The legal and non-legal information evaluation results of Xueshuantong for injection（lyophilized） showed that all the information was complete and in accordance with the requirements of national standards. Based on the grade scores of the 6 dimensions， the clinical comprehensive evaluation of Xueshuantong for injection（lyophilized） in the treatment of ACI was calculated as category B by CSC 2.0. ConclusionThe clinical value of Xueshuantong for injection（lyophilized） is good， and it is suggested that it can be directly translated into relevant policy outcomes for basic clinical medication management.
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An explicit illustration of pulmonary delivery processes (PDPs) was a prerequisite for the formulation design and optimization of carrier-based DPIs. However, the current evaluation approaches for DPIs could not provide precise investigation of each PDP separately, or the approaches merely used a simplified and idealized model. In the present study, a novel modular modified Sympatec HELOS (MMSH) was developed to fully investigate the mechanism of each PDP separately in real-time. An inhaler device, artificial throat and pre-separator were separately integrated with a Sympatec HELOS. The dispersion and fluidization, transportation, detachment and deposition processes of pulmonary delivery for model DPIs were explored under different flow rates. Moreover, time-sliced measurements were used to monitor the PDPs in real-time. The Next Generation Impactor (NGI) was applied to determine the aerosolization performance of the model DPIs. The release profiles of the drug particles, drug aggregations and carriers were obtained by MMSH in real-time. Each PDP of the DPIs was analyzed in detail. Moreover, a positive correlation was established between the total release amount of drug particles and the fine particle fraction (FPF) values ( = 0.9898). The innovative MMSH was successfully developed and was capable of illustrating the PDPs and the mechanism of carrier-based DPIs, providing a theoretical basis for the design and optimization of carrier-based DPIs.
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Objective To analyze the effect of edaravone combined with ginkgo diterpene lactone in treatment of acute cerebral infarction (ACI) and discuss the better clinical treatment to ACI .Methods 100 cases of ACI and who accepted treat-ments in our hospital were selected as the research objects in January 2014 to January 2015 .50 patients as observation group were given the treatment of edaravone and ginkgo diterpene lactone at the same time ,while other 50 patients as control group were merely given the treatment of ginkgo diterpene lactone .At the same time ,both groups were given treatment of conven-tional therapy .The total neurological function ,effective rate ,adverse reactions ,and the treatment satisfaction of both groups before and after the treatment were observed .Results There were no significant different of NIHSS score of two groups before treatment (P>0 .05) .After treatment ,NIHSS score of the observation group was significantly lower than the control group (P<0 .05) .The total effective rate of observation group was 90％ ,which was significantly higher than the control group (66％ ,P<0 .05) .The main adverse reactions were rash ,nausea ,dizziness of two groups ,and there were no significant differ-ent of adverse reactions rate of two groups through the treatment (P>0 .05) .The treatment of patients with satisfaction rate of observation group was 94％ ,which was significantly higher than control group (84％ , P< 0.05) .Conclusion Edaravone combined with ginkgo diterpene lactone had a good effect on improving nerve function of ACI patients ,which could improve the treatment of patients with satisfaction ,high security ,and could be recommended in clinical .
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Objective To observe the Hp infection effect on blood lipid metabolism and oxidative stress through detecting acute cerebral infarction (ACI) with Helicobacter pylori (Hp) infection serum lipid and malondialdehyde (MDA) level and superoxide dismutase (SOD) activity.Methods Chose ACI 350 cases of ACI group,80 cases of control group and detected serum Hp-IgG antibody (by colloidal gold) and 14C urea breath test (by14 C-UBT).Used the American beckman coulter AU680 fullautomatic biochemical analyzer to detect the serum lipid and SOD activity (colorimetry),and used Shanghai now 752 visible spectrophotometcr (532 nm) to detect the serum MDA level (TBA).Results The Hp infection rate of ACI group (69.5 ％) was significantly higher than that in the control group (33.8％),the differences was statistically significant (x2 =18.882,P＜0.01).The differences in serum TC,TG,LDL-C and HDL-C levels were statistically significant (t=4.167 ～5.521,all P＜0.01) compared with Hp non-infection group.The serum MDA level and SOD activity of the control group and Hp infection group were statistically significant (F=34.891～46.613,all P＜0.01).Hp infection with Hp infection group to compare serum MDA level and SOD activity differences statistically significant (t=5.197,9.713,all P＜0.01),the Hp infection group and control group in comparative differences were statistically significant (t=3.173,8.228,all P＜0.01).Conclusion Acute cerebral infarction merger of HP infection,blood lipid metabolic disturbance in body increased and enhanced oxidative stress reaction,this may be intensified HP infection is one of the reasons for acute brain infarction dis ease.
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RESUMEN OBJETIVOS: Evaluar los efectos del consumo de ácidos grasos omega 3 en forma de suplementos, complementos o alimentos sobre la función cognitiva de los adultos. MÉTODOS: Se realizó una revisión de la literatura en las bases de datos Medline y Embase, buscando ensayos clínicos, estudios observacionales, revisiones sistemáticas y estudios experimentales que relacionaran los ácidos grasos omega 3 con función cognitiva y Alzheimer. RESULTADOS: La mayoría de los estudios relacionó la suplementación de cápsulas con omega 3, el consumo de pescado u otros alimentos con contenido de omega 3, con resultados en pruebas de función cognitiva, desenlace de enfermedad o imágenes diagnósticas, encontrando en general efectos benéficos, que parecen ser mayores en personas sanas y con mejor función cognitiva de base. Hubo diferencias en los resultados encontrados en los ensayos clínicos y revisiones sistemáticas, que podrían atribuirse a la variabilidad en las dosis de la suplementación, el tiempo de seguimiento y la manera en que se midió la función y el deterioro cognitivo. CONCLUSIÓN: El consumo de ácidos grasos omega 3 en forma de suplementos, complementos o alimentos ricos en estos como el pescado parece tener efectos benéficos en la función cognitiva de las personas adultas.
SUMMARY OBJECTIVES: To evaluate the effects of omega 3 fatty acids consumption in the form of dietary supplement, complement or food-products presentation on adult cognitive function. METHODS: A literature review in two databases (Medline and Embase) was undertaken, searching for clinical trials, observational studies, systematic reviews and experimental studies concerning omega-3 fatty acids and their relation with cognitive function and Alzheimer's disease. RESULTS: Most studies linked supplementation with omega-3 capsules and consumption of fish and other omega-3 containing foods with results in cognitive function testing, outcomes in diseases or diagnostic imaging and found beneficial effects, which seem to be stronger in healthier persons with better cognitive function at baseline. There were differences in the results found in clinical trials and systematic reviews, which could be attributable to the variability in the supplementation dose, the length of follow-up and the methods used to assess cognitive function and decline. CONCLUSION: The use of omega-3 fatty acids in supplement, complement or food-products presentation seems to have beneficial effects in the cognitive function of healthy adults.
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Ácido Eicosapentaenoico , Cognición , Ácidos Grasos , Enfermedad de AlzheimerRESUMEN
Objective The detection results of intestinal virus nucleic acid related to HFMD( hand,foot and mouth disease)from the anal swabs and throat swabs were compared so as to explore more effective methods for laboratory diagnostic of the disease. Methods Real-time fluorescence quantitative polymerase chain reaction (PCR)was used to detect RNA of enterovirus 71(EV71),coxsackievirus A16(CA16),and other enterovirus (EV)in the paired samples. The virus detection results from the two sample types were compared to find out the miss rate in a single sample. Results The detection rates of EV71,CA16 and Non-EV71/Non-CV16 enterovirus (Non-EV71/Non-CV16 EV)in the anus swabs/ throat swabs were 17.25%/12.18%,4.03%/3.54% and 40.28%/45.32%,respectively. Obviously ,the detection rates of EV71 and CA16 in anal swabs were higher than those in throat swabs ,while the detection rates of Non-EV71Non-CV16 EV was lower than that in throat swabs. The differences were statistically significant(P<0.05). Compared with the detection results of the paired samples ,the miss rate of a virus in a single sample type ranged from 10.33%to 36.27%. Conclusion The detection miss rates of HFMD related intestinal virus nucleic acid in one sample type(anal swabs or throat swabs)are high,while tak-ing the detection in the paired samples can significantly improve the detection rate.
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Objective To explore pathogenes and pathogenesis of acute cerebral infarction (ACI) from the perspective of integrated traditional and western medicine.Methods To categorize the tongue and pulse manifestation of 64 ACI patients and calculate their frequency,constituent ratios.Meanwhile,patients' blood pressure and laboratory examination results are given descriptive and statistical analysis,showing their means and standard deviations,etc.Results The frequency of dark-red tongue,thin-greasy tongue fur,greasy-yellow tongue fur and taut-slippery is respectively 48,34,20,and 41,constituting 77.4％,54.8％,32.3％,64.1％ of the patients examined respectively; Mean and standard deviation of systolic blood pressure (SBP),total cholesterol (TC),white blood cell (WBC),neutrophil percentage (NEUT％),fasting plasma glucose (FPG),and hemoglobin A1c (HbA1c) is respectively (141.20± 19.20)mm Hg (1 mm Hg=0.133 kPa)、(4.47±0.97) mmol/L、(7.83±2.63) × 109/L、(71.61±9.65)％、(6.16±2.25)mmol/L、and (6.60±1.66)％.Conclusion In terms of pathogens,wind,stasis,heat (fire) and turbid pathogen (phlegm,dampness,etc.) are important factors in bringing out ACI; In respect of ACI pathogenesis characteristics,healthy qi is slightly damaged and pathogenic qi is exuberant.Yet,the role of modern medical examination results,such as blood pressure,blood glucose,blood lipids etc.in the assessment of ACI pathogens and pathogenesis awaits further exploration.
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The natural history after articular cartilage injury is unclear. However, it is generally accepted that once articular cartilage is injured, its ability to regenerate is limited and that injury progresses to arthritis with time. Over the years various treatments have been developed and are used, such as arthroscopic debridement, microfracture, multiple drilling, osteochondral transfer, and Autologous Chondrocyte Implantation (ACI). These can be divided into treatment methods which apply cells and those which apply tissue. The former include abrasion chondroplasty, microfracture, multiple drilling, and ACI. The latter include osteochondral transfer and allograft. Combination treatments using both cells and tissues are new-generation ACI and microfracture with biomaterials. The clinical applications of stem cell therapy is still at an early stage, but shows much promise, particularly in the management of cartilage defects.
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Artritis , Materiales Biocompatibles , Cartílago , Cartílago Articular , Condrocitos , Desbridamiento , Rodilla , Mandrillus , Historia Natural , Células Madre , Trasplante HomólogoRESUMEN
Aims: Cartilage is frequently damaged through injury and disease but shows little or no capacity for repair. Injuries that extend to the subchondral level show some capacity for repair due to the release of bone marrow derived mesenchymal stem cells. Focal articular cartilage defects are challenging clinical problems that may progress to more generalised lesions. We reviewed the literature to analyse the results of available noncell- based and cell-based strategies for the repair of articular cartilage defects in the knee. Study design: Review Article Place and Duration of Study: University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom Methodology: We reviewed the literature to identify studies on the use of non-cellbased and cell-based strategies for the repair of articular cartilage defects in the knee. Results: Repair techniques that do not utilise cell therapy include bone marrow stimulating techniques such as microfracture that is effective in small well-contained lesions and has the advantages of being performed arthroscopically as a single stage and cheaper costs compared to cell-based therapies. It also associated with no donor site morbidity unlike mosaicplasty, and perichondrial or periosteal grafting. The evidence suggests that none of the techniques described above consistently produce durable results. There are encouraging mid-term results with Autologous Matrix Induced Chondrogenesis (AMIC) procedures in small number of patients. Although microfracture is appropriate for smaller cartilage defects, Autologous Chondrocyte Implantation (ACI) and Matrix-carried Autologous Chondrocyte Implantation (MACI), as well as other cell carrier systems, are currently used to treat larger full thickness chondral defects in the knee. Although the results are fairly similar, MACI and procedures using other cell carrier systems are amenable to be performed arthroscopically or through a more limited approach. There are a small number of studies using mesenchymal stem cells with promising early results bur further in vitro and in vivo studies are needed before this treatment becomes more routinely available. Conclusion: Focal articular cartilage defects are challenging clinical problems that progress to more generalised lesions. Only cartilage injuries that extend to the subchondral level show some capacity for repair due to the release of bone marrow derived mesenchymal stem cells. Bone marrow stimulating techniques such as microfracture are effective in small well-contained lesions (<2cm2) and have the advantages of being performed arthroscopically as a single stage and cheaper costs compared to cell-based therapies. Mosaicplasty, and perichondrial or periosteal grafting are associated with donor site morbidity. Longer term studies on AMIC may help define the role for this procedure. The best form of non-cell-based treatment for focal articular cartilage defects in the long term is still unknown. ACI and MACI, as well as other cell carrier systems, are currently used in clinical practice to treat larger full thickness chondral defects in the knee. There are a small number of studies using mesenchymal stem cells and further in vitro and in vivo studies are needed before this treatment is optimised.
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PURPOSE: To investigate whether c-Jun, Bcl-2 and Bax expressions are altered in rat hippocampus after kainic acid (KA)-induced seizures, and to determine whether such changes correlate with apoptotic cell death. METHODS: Forty male Sprague-Dawley rats were used. Thirty rats were assigned to the experiment group, and 10 rats the control. KA (20 mg/kg) was injected once intraabdominally. The behavioral patterns were observed after the injection. The rats' brain was extracted 4, 24, and 72 hours after KA injection. c-Jun, Bcl-2 and Bax expression were evaluated by immunohistochemistry, and apoptosis by TUNEL staining. The expression of c-Jun, Bcl-2 and Bax at each hippocampal region were compared, and the relationship between c-Jun, Bcl-2 and Bax expression, and apoptosis was investigated. RESULTS: c-Jun expression was increased at CA1, CA3 and CA4 regions 4 hours after the injection, and the increased expression was continued to 72 hours at CA3 region. Bcl-2 expression was increased at CA1, CA3 and CA4 regions 4 and 24 hours after the injection, and the increased expression was continued to 72 hours at CA3 region. Bax expression was increased at CA3 and CA4 regions 4 hours after KA injection, and the increased expression was continued to 72 hours at CA3 region. Apoptosis was significantly increased at CA3 region 4 hours after KA injection. CONCLUSION: c-Jun expression was increased in hippocampus after KA-induced seizures, and cell death-regulating proteins Bcl-2 and Bax expression, and apoptosis were increased at similar regions. These results suggest that c-Jun might be activated in KA-induced apoptotic cell death mechanism.
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Animales , Humanos , Masculino , Ratas , Apoptosis , Encéfalo , Muerte Celular , Hipocampo , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Ácido Kaínico , Ratas Sprague-Dawley , ConvulsionesRESUMEN
OBJECTIVE:To evaluate the cost-effectiveness of 3 "Cocktail" therapeutic regimens in treating acute cerebral infarction(ACI).METHODS:141 patients with ACI were administered with Sodium Ozagrel + Cinepazide + Edaravone(Group A),Vinpocetine + Propylgallate + Deproteinized calf blood Extractives(Group B)or Sodium Ferulate + Buflomedil + Muscular Amino Acids and Peptides and Nucleosides(Group C)for 14d.Cost-effectiveness analysis in pharmacoeconomics was applied to analyze the therapeutic effects and costs.RESULTS:The total costs of 3 groups(A,B and C)were 5 970.67 yuan,4 865.11 yuan and 3 939.72 yuan,respectively,the efficiency rates were 82.98%,63.04% and 64.58% respectively,and the cost-effectiveness ratio were 7 195.31,7 717.50 and 6 100.53,respectively.CONCLUSION:Group A is preferable for ACI.
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Objective To introduce the amino acid substitution for HP V16E749-57(HLA-A2-restricted CTL epitope) and to identify the novel epitopes.Me thods Quantitative method was used to evaluate the affinity of the substituted peptides.To determine the peptide candidates to be synthesized and identified,the molecular models of the HLA-A2-peptide complex and CTL epitope candidates b ound to the HLA-A2 molecule were established by computer molecular modeling.Pep tides were synthesized and purified with standard Fmoc assay,lactate dehydrogen ase (LDH) release assay was used to determine their abilities of inducing the ge neration of specific CTLs.Results Modified peptides met the requirements of H LA-A2-restricted CTL epitopes.Peptide RLHYNIVTF had the abilitiy of inducing th e generation of specific CTLs.Conclusions Compared with HPV17E749-57 the mod ified peptide RLHYNIVTF has a higher antigenicity and affinity to HLA-A2.So,pe ptide RLHYNIVTF may be used as one of the HLA-A2-restricted candidate epitopes,instead of HPV17E749-57,for peptide vaccine in the treatment of HPV infection.
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The therapeutic effect and laboratory findings in 137 case of acute cerebral infarction treated with Propylene Glycol Mannurate Sulfate (PGMS) were analysed. The positive therapeutic response to PGMS in the treated group was obtained to 95. 6% and 70. 1%,and was better than that of the controls ( P