目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病...目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。展开更多
Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions...Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions of strengthening“Yang Qi”(one of the fundamental concept in TCM,representing the active,warming,and energizing force within the body.It governs physiological functions,maintains body temperature,and promotes vitality.Balanced“Yang Qi”supports immunity and metabolism,while deficiency may lead to fatigue,cold intolerance,or weakened resilience),promoting blood circulation,and removing blood stasis,and nourishing yin based on the TCM theory.Previous studies have found that it significantly improved BPH and regulate urinary function in estrogen and androgen-induced rats.However,it is unclear whether DZQE has an inhibitory effect on BOO rats.Methods:Male Wistar rats underwent retropubic partial bladder neck ligation to induce BOO.DZQE extract(2.7/5.4 g/kg)was administered orally for 35 days.Anesthetized rats underwent cystometry to assess BOO and treatment effects on urinary parameters.Bladder histopathology,fibrosis,and PCNA expression were evaluated via HE,Masson’s,and IHC staining.Western blot quantified bladder tissue levels of choline acetyltransferase(ChAT),rho-associated protein kinase 1(ROCK1),myosin light chain kinase(MLCK),myosin light chain 2(MLC-2),extracellular signal-regulated kinase(ERK),proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax).Primary bladder smooth muscle cells were cultured,exposed to hydrostatic pressure(HP,3 h/24 h)using a custom apparatus to mimic BOO,and treated with DZQE components for Western blot analysis of ROCK1,MLCK,ERK,PCNA,and Bax.Results:The bladder hyperplasia,bladder index(BI)increased,and histopathological alteration were easily observed in BOO group,which were significantly inhibited by DZQE administration.DZQE also significantly inhibited the up-regulation of maximum voiding pressure(MVP)and down-regulation of residual urine volume(RV)observed in BOO rats.The expressions of ChAT and MLCK and the activation of ERK were much increased,while the expressions of ROCK1,MLC-2 and Bax were obviously decreased in BOO rats,all of which were then significantly inhibited by DZQE.In rat bladder smooth muscle cells(RBSMC),3 h or 24 h duration of HP successfully simulated the BOO compensation and decompensation respectively in vitro.DZQE or its active components reduced the abnormal gene expressions in HP stimulated RBSMC.Conclusion:DZQE improves the urinary function in BOO rats mainly through the activation of ERK.Bakuchiol,salvianolic acid A,kaempferol,and tanshinoneⅡA are possibly the important active components of its therapeutic effects.展开更多
文摘目的:回顾性分析普通射频联合低温等离子射频消融术与膝关节腔内注射羧甲基壳多糖(医用几丁糖)治疗顽固性膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性。方法:纳入2020年2月至2021年3月中日友好医院疼痛科收治的顽固性KOA病人66例,根据治疗方法不同分为手术组35例和注射组31例,分别在术前、术后第2周、1个月、3个月、6个月、12个月应用疼痛数字分级评分法(numerical rating scale,NRS)评分、西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎评分、药物使用率、手术相关并发症、病人的满意度进行随访评估以及统计学分析。结果:与术前相比,手术组疗效优于注射组,在术后2周、1个月、3个月、6个月、12个月手术组NRS评分和WOMAC评分、术后药物使用率均明显下降;两组术后均未观察到下肢麻木、下肢无力、感觉减退、感觉异常、神经痛等严重不良反应。术后12个月,手术组82.9%的病人对术后疗效满意,注射组38.7%的病人对术后疗效感到满意。结论:膝神经射频联合低温等离子射频消融术可以有效缓解膝关节疼痛,改善关节功能,且未发现严重不良反应,可以作为全膝关节置换术以外的顽固性KOA的替代治疗模式。
基金supported by The National Key Research and Development Project of China(No.2023YFC3504302)the National Natural Science Foundation of China(General Program No.82074105).
文摘Background:Bladder outlet obstruction(BOO)is a prevalent urinary system disease main caused by benign prostatic hyperplasia(BPH)in males.Traditional Chinese medicine(TCM)Danzhi qing’e decoction(DZQE)has the functions of strengthening“Yang Qi”(one of the fundamental concept in TCM,representing the active,warming,and energizing force within the body.It governs physiological functions,maintains body temperature,and promotes vitality.Balanced“Yang Qi”supports immunity and metabolism,while deficiency may lead to fatigue,cold intolerance,or weakened resilience),promoting blood circulation,and removing blood stasis,and nourishing yin based on the TCM theory.Previous studies have found that it significantly improved BPH and regulate urinary function in estrogen and androgen-induced rats.However,it is unclear whether DZQE has an inhibitory effect on BOO rats.Methods:Male Wistar rats underwent retropubic partial bladder neck ligation to induce BOO.DZQE extract(2.7/5.4 g/kg)was administered orally for 35 days.Anesthetized rats underwent cystometry to assess BOO and treatment effects on urinary parameters.Bladder histopathology,fibrosis,and PCNA expression were evaluated via HE,Masson’s,and IHC staining.Western blot quantified bladder tissue levels of choline acetyltransferase(ChAT),rho-associated protein kinase 1(ROCK1),myosin light chain kinase(MLCK),myosin light chain 2(MLC-2),extracellular signal-regulated kinase(ERK),proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax).Primary bladder smooth muscle cells were cultured,exposed to hydrostatic pressure(HP,3 h/24 h)using a custom apparatus to mimic BOO,and treated with DZQE components for Western blot analysis of ROCK1,MLCK,ERK,PCNA,and Bax.Results:The bladder hyperplasia,bladder index(BI)increased,and histopathological alteration were easily observed in BOO group,which were significantly inhibited by DZQE administration.DZQE also significantly inhibited the up-regulation of maximum voiding pressure(MVP)and down-regulation of residual urine volume(RV)observed in BOO rats.The expressions of ChAT and MLCK and the activation of ERK were much increased,while the expressions of ROCK1,MLC-2 and Bax were obviously decreased in BOO rats,all of which were then significantly inhibited by DZQE.In rat bladder smooth muscle cells(RBSMC),3 h or 24 h duration of HP successfully simulated the BOO compensation and decompensation respectively in vitro.DZQE or its active components reduced the abnormal gene expressions in HP stimulated RBSMC.Conclusion:DZQE improves the urinary function in BOO rats mainly through the activation of ERK.Bakuchiol,salvianolic acid A,kaempferol,and tanshinoneⅡA are possibly the important active components of its therapeutic effects.
