Meta-analysis of the efficacy of recombinant human growth hormone and human serum albumin in the treatment of liver cirrhosis with hypoproteinemia / 中国基层医药

Objective:To evaluate the efficacy, safety and economy of recombinant human growth hormone (rhGH) in the treatment of patients with liver cirrhosis and hypoproteinemia.Methods:Computer search for randomized controlled trials included in Chinese Biomedical Literature Database(CBM), Wanfang Medicine, Weipu Medicine, Embase, PubMed, Cochrane Library and other databases from January 1, 2000 to January 1, 2019, and excluded according to certain criteria.RevMan5.3 software was used for statistical analysis.Results:A total of 13 articles were included in the meta-analysis, a total of 739 patients.The results showed that the short-term efficacy of rhGH in the treatment of cirrhosis with hypoproteinemia had no statistically significant difference compared with human serum albumin (HSA)[WMD=-0.42, 95% CI(-1.77, 0.92), P=0.54], but the mid-and long-term effects of rhGH were better[WMD=3.42, 95% CI(0.13, 6.70), P=0.04; WMD=7.12, 95% CI(4.75, 9.50), P<0.001]. Conclusion:The application of rhGH in the treatment of cirrhosis with hypoproteinemia is equivalent to the infusion of HSA in short-term efficacy, but the duration of treatment is prolonged, has no obvious adverse reactions, and is more economical.

Treatment of lumbar degenerative disease with modified transforaminal lumbar interbody fusion / 中国医师进修杂志

Objective To investigate the chnical effect of modified transforaminal lumbar interbody fusion (TLIF) on the treatment of lumbar degenerative disease. Methods Sixty-two patients with lumbar degenerative disease were treated by the modified TLIF from June 2007 to May 2009. The preoperative diagnosis was lumbar intervertebral disc herniation with spinal instability (28 cases), lumbar intervertebral disc herniation with lumbar stenosis (27 cases ), degenerative spondylohsthesis (7 cases ). Forty-eight cases were single-level and 14 cases were two-level. The patients were evaluated by observing the fusion rate and comparing the visual analog score( VAS ) and Japanese orthopaedics association (JOA) score of preoperation with those of postoperation. Results All the patients were followed up from 15 to 30 (22.77 ± 3.82)months,no nerve injury,leakage of cerebralspinal,infection,the broken of pedical screws and other complications. The fusion rate of segment was 96.8% at the follow-up after 1 year postoperatively. Judgement by JOA score,the rate of improvement was 93.5%(58/62),excellent in 34 cases,good in 24 cases,fair in 4 cases. The postoperative value of V AS and JOA score were higher than those of preoperation (P ＜ 0.05 ), the values when follow-up of 3 months was performed had no statistic al difference with those of final follow-up (P＞0.05). Conclusion The modified TLIF with fully decompression while reducing the accessing spinal canal complications have good clinical efficacy in treating lumbar degenerative disease.

Single cage plus unilateral pedicle screw placement for treating lumbar degenerative instability in 51 cases / 中国组织工程研究

BACKGROUND: Most of the patients suffered from degenerative lumbar instability are treated by exposure both sides and bilateral pedicle screw fixation,which bring highly operative risk,large blood loss and great medical expenditure to patients.OBJECTIVE: To explore the clinical efficacy of single cage plus unilateral pedicle screw placement for treating lumbar degenerative instability.METHODS: Totally 51 cases with lumbar degenerative instability underwent single cage plus unilateral pedicle screw placement were selected,including 32 males and 19 females,aged ranging from 41 to 72 years.47 cases had single segment involved and 4cases had two segments involved.All cases experienced unilateral laminectomy and transforamenal lumbar interbody fusion.The therapeutic effect was assessed by Japanese Orthopaedic Association(JOA)score system.RESULTS AND CONCLUSION: The blood loss was 90-430 mL.The surgical time was 100 minutes(85-120 minutes)for single segment and 150 minutes(120-170 minutes)for double segments.The patients were allowed to early ambulation at 2-3 days after operation.Two cases did not get improvement on back-leg pain,but there was no abnormality from CT and MRI recheck,one case felt pain relieved after anti-symptom treatment for 3 months while the other did not relieve.The average JOA scores at pre-operation and 1 year follow-up was 11(7-13 scores)and 25(18-27 scores),respectively.The total improvement rate of JOA was larger than 50%.44 cases were evaluated as fusion and 7 cases as possible fusion.The average fusion time was 5.4 months(4.3-7.1 months).Postoperative X-ray showed no evidence of pedicle screw loosening,broken,or cage displacement.Single cage plus unilateral pedicle screw placement is characterized by simple operation,small blood loss,short operation and few interference to spine,which is a better method for treating lumbar degenerative instability.

Apoptosis and expression of iNOS after spinal cord injury in rats / 中国康复理论与实践

@# ObjectiveTo study the characteristic of apoptosis and the expression of inducible nitric oxide synthase(iNOS),as well as relation between them after spinal cord injury (SCI) in rats.Methods84 adult SD rats were randomly divided into three groups,and made into mild,moderate and severe acute SCI models.The rats were killed at 4h,8h,1d,3d,7d,14d and 21d after surgery.The histopathology changes in spinal cord tissue were observed with HE staining microscopic examination.The expression of iNOS was determined by immunohistochemistry and the apoptosis was labeled by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL).ResultsThe histopathology changes in spinal cord tissue deteriorated with increasing in injury degree.A little iNOS immunoreactivity (iNOS-IR) was detected in nerve cells,gliocytes,ependymocytes and blood vessel endotheliocytes of normal and vertebra shelf operated controls,increasing at 8 h, and in flood tide in 7 d. The expression of Bax and the rates of TUNEL positive cells were similar with that of iNOS after SCI. There was positive correlation between expression of iNOS and degree of primary SCI ,apoptosis index(r=0.414,P<0.01;r=0.854,P<0.01).Conclusions Expression of iNOS and Bax increase and a large number of TUNEL positive cells present after SCI in rats. There is positive correlation between expression of iNOS and degree of primary SCI,apoptosis index.