Effect of Tongluozhitong Prescription-Assisted Intra-Articular Injection of Sodium Hyaluronate on VAS Score and Knee Lysholm Score in Patients with Knee Osteoarthritis.

Knee osteoarthritis (KOA) has become one of the leading causes of workforce loss in the middle-aged and elderly population and a global public health problem second only to cardiovascular disease, so we need to find more effective treatments for this disease. In this study, we selected 120 patients with KOA admitted to our hospital from June 2018 to December 2020 and divided them into treatment group 1, treatment group 2, and joint group according to the random number table method, with 40 patients in each group. Treatment group 1 was treated with Tongluozhitong prescription dip-soaking therapy, treatment 2 group was treated with intra-articular injection of sodium hyaluronate, and the joint group was treated with a combination of both modalities for 4 weeks in all three groups. Clinical efficacy, visual analogue scale (VAS), Lysholm knee score (LKS), activity of daily living score (ADL), the levels of bone metabolic markers such as cartilage oligomeric matrix protein (COMP), type II collagen degradation maker (CTX-II), and matrix metalloproteinase-3 (MMP-3), and the levels of inflammatory mediators such as interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α), and hypersensitive C-reactive protein (hs-CRP) were used as observations to compare and analyze the therapeutic effects of the three treatment regimens in KOA patients. The results showed that the clinical excellence rates of the joint group, treatment group 1, and treatment group 2 were 72.50%, 50.00%, and 90.00%, respectively, with statistically significant differences between any two comparisons. After treatment, VAS scores, serum COMP, CTX-II, MMP-3, IL-1ß, TNF-α, and hs-CRP levels decreased in all three groups, and the levels of each index were as follows: joint group < treatment group 1 < treatment group 2, and the difference between any two comparisons was statistically significant. The LKS score and ADL score increased in all three groups, and the levels of each index were as follows: joint group > treatment group 1 > treatment group 2, with statistically significant differences in any two groups compared. None of the patients in the three groups experienced any significant adverse effects during treatment. This suggests that the dip-soaking therapy of Tongluozhitong prescription is more advantageous than intra-articular sodium hyaluronate injection treatment in suppressing the level of serum bone metabolic markers and inflammatory mediators, reducing pathological joint damage, relieving symptoms of pain, alleviating degenerative joint symptoms, and improving knee function in KOA patients. The combination of the two in KOA patients can significantly improve the efficacy and has a good safety profile.

Efficacy and safety of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia: A meta-analysis with trial sequential analysis of 23 randomised controlled trials.

To further identify the real efficacy and safety of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia, we conducted this meta-analysis. The systematic search strategy was performed using PubMed, Embase, Cochrane Library, and Chinese databases. As a result, a total of 23 RCTs (1445 patients) were included. Patients receiving dexmedetomidine combined with local anaesthetics had a lower rescue analgesia rate [risk ratio (RR): 0.48; 95% confidence interval (CI): 0.36-0.65] and lower rescue analgesic consumption [weighted mean difference (WMD): -10.80 mg; 95%CI: -13.28 to -8.31 mg] than patients receiving local anaesthetics alone. The dexmedetomidine-related adverse reactions included bradycardia (RR: 1.33; 95%CI: 0.32-5.56) and hypotension (RR: 3.00; 95%CI: 0.49-18.42). In addition, the time to first analgesic request (WMD: 296.16 minutes; 95%CI: 165.69 minutes ~ 426.63 minutes), incidence of postoperative nausea and vomiting (PONV) and pain scores at 4 hours postoperatively were also significantly lower in patients receiving dexmedetomidine combined with local anaesthetics. This meta-analysis demonstrated that the use of dexmedetomidine as an adjuvant to wound infiltration is effective for reducing the rescue analgesia rate, rescue analgesic consumption and PONV. In addition, limited evidence shows that dexmedetomidine can prolong postoperative analgesia for approximately 5 hours. Further investigations on dexmedetomidine-related adverse reactions and the dose-response effect of dexmedetomidine in wound infiltration are warranted.

[The effect of uvulopalatopharyngoplasty by radio frequency plasma].

OBJECTIVE: To study the effect of uvulopalatopharyngoplasty(UPPP) by using radio frequency plasma on obstructive sleep apnea-hypopnea syndrome(OSAHS) with velopharyngeal obstruction. METHOD: Eighty-one cases that were diagnosed as OSAHS with Velopharyngeal obstruction were randomized into two groups, UPPP group and radio frequency plasma Uvulopalatopharyngoplasty group. RESULT: Six months after operation, the effects in both groups were similar. CONCLUSION: Radio frequency plasma Uvulopalatopharyngoplasty is safe, time saving, less hemorrhage with good effects.

[Clinical analysis of solitary sphenoid sinus disease].

OBJECTIVE: To explore the clinical characters and treatment on solitary sphenoidal sinus disease thus improve the initial diagnosis accuracy and curative rate together with avoiding severe complications. METHOD: Forty-six cases were included in the study. The clinical manifestations, medical imaging characteristics and type of pathology and surgical treatment efficacy were analyzed retrospectively. RESULT: The main symptoms were headache and visual lesion. Medical image showed pace occupying lesion and partial destruction of bone. Pathological exams showed 8 cases with sphenoiditis, 19 cases with fungal infection, 10 cases with cysts and 9 cases with polyposis. All the patients underwent open sphenoidal surgery with nasal endoscope. After a follow-up of over 6 months, most of the patients' symptoms had been obviously relieved. And the entrance to sphenoid was patent with smooth sinus wall and no secretion in sinus cavity. CONCLUSION: There is no specificity with solitary sphenoidal sinus disease. Pre-operation diagnosis rate can be improved with the help of nasal endoscope and CT or MRI. Nasal sinus surgery with nasal endoscope may be the first choice for treatment.