Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal ...Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.展开更多
The soothing efficacy of baby moisturizer was evaluated by analyzing the changes of inflammatory cytokines in vitro and human efficacy tests.RAW264.7 cells were induced by Lipopolysaccharide(LPS) to establish a cell i...The soothing efficacy of baby moisturizer was evaluated by analyzing the changes of inflammatory cytokines in vitro and human efficacy tests.RAW264.7 cells were induced by Lipopolysaccharide(LPS) to establish a cell inflammation model in vitro,and the inflammatory cytokines of Interleukin-6 (IL-6) and NO were detected to observe the inhibitory effect of baby moisturizer in vitro.The non-toxic concentration of baby moisturizer was detected by MTT assay,the level of IL-6 in RAW264.7 cells supernatant was detected by ELISA kits,and the level of NO in RAW 264.7 cells supernatant was detected by Griess reagent.Dexamethasone was used as the positive control.At the same time,the hydration of the stratum corneum,transepidermal water loss (TEWL),erythema index,the redness of skin (a^(*) value) and the proportion of redness area in facial cheekbones were detected after using the baby moisturizer for 28 days.The experiment results showed that the baby moisturizer at a non-toxic concentration of 0.3 mg/mL,could significantly reduce IL-6 and NO in RAW264.7 cells supernatant,meanwhile it could significantly enhance the hydration of the stratum corneum,and reduce the TEWL,erythema index,the redness of skin (a^(*) value) and the proportion of redness area.In conclusion,the baby moisturizer (0.3 mg/mL) can restrain inflammatory cytokines in vitro and can also significantly improve human facial skin irritation,which can be considered to have soothing efficacy.展开更多
Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medic...Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.展开更多
This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner rel...This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.展开更多
Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affec...Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.展开更多
[Objectives]To systematically evaluate the clinical efficacy of head massage combined with Chinese herbal bath in treating insomnia and analyze its herbal medication patterns.[Methods]Clinical data of 200 chronic inso...[Objectives]To systematically evaluate the clinical efficacy of head massage combined with Chinese herbal bath in treating insomnia and analyze its herbal medication patterns.[Methods]Clinical data of 200 chronic insomnia patients treated at the Sleep Disorder Center of Taihe Hospital from January 2020 to December 2024 were retrospectively analyzed.Patients were randomly divided into observation group and control group(n=100 each).The observation group received head massage combined with Chinese herbal bath therapy,while the control group received Chinese herbal bath alone.The Pittsburgh Sleep Quality Index(PSQI)was used for efficacy evaluation,and statistical analysis was performed on the frequency of herbal medications in herbal herbal bath formulas.[Results]The PSQI score improvement in the observation group(8.44±1.87)was significantly better than that in the control group(5.74±1.93)(P<0.01).Herbal formulas for external bath primarily contained mind-calming and heart-nourishing herbs(fried Ziziphi Spinosae Semen,Concha Margaritifera)and heat-clearing herbs(Rhizoma Coptidis,Radix Scutellariae).[Conclusions]The combination of head massage and Chinese herbal bath can significantly improve sleep quality in insomnia patients,demonstrating superior clinical efficacy compared with Chinese herbal bath alone.This combined therapy shows good safety and operability,warranting promotion in primary and specialized medical institutions.展开更多
Given that the citrus psyllid is the primary vector of citrus Huanglongbing(HLB),there is an urgent need to control this pest to mitigate the spread of the disease.This paper reviews the current research on two predom...Given that the citrus psyllid is the primary vector of citrus Huanglongbing(HLB),there is an urgent need to control this pest to mitigate the spread of the disease.This paper reviews the current research on two predominant control strategies:chemical control and biological control agents,in managing the citrus psyllid.It emphasizes the mechanisms of action,efficacy,and application advancements of these control methods.Finally,the paper analyzes the principal challenges associated with the sustainable management of citrus psyllids and offers perspectives for future research.展开更多
[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patie...[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.展开更多
Objective:To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma.Methods:A retrospective study was conducted on 102 patie...Objective:To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma.Methods:A retrospective study was conducted on 102 patients with advanced urothelial carcinoma treated at our hospital between March 2021 and August 2024.Based on treatment regimens,patients were divided into a chemotherapy group(n=52)and a combination group(n=50).The chemotherapy group received the GC chemotherapy regimen,while the combination group received GC chemotherapy combined with toripalimab.Both groups underwent 4-6 cycles of treatment based on patient tolerance.Clinical efficacy,immune-related factor levels,survival outcomes,and safety were observed and compared.Results:The disease control rate(DCR)and overall response rate(ORR)in the combination group were slightly higher than those in the chemotherapy group,but the differences were not statistically significant(P>0.05).After treatment,levels of IFN-γand IL-2 increased significantly,while VEGF levels decreased significantly in both groups(P<0.05),with superior outcomes observed in the combination group(P<0.05).Follow-up analysis showed progression-free survival(PFS)and median overall survival(OS)in the chemotherapy group were 5.19 and 10.15 months,respectively,compared to 8.24 and 18.23 months in the combination group,with statistically significant differences(P<0.05).During treatment,the incidence of adverse reactions such as rash,immune-related pneumonia,and immune-related diarrhea was higher in the combination group than in the chemotherapy group(P<0.05).However,the incidence of gastrointestinal reactions,fever,and leukopenia did not differ significantly between the two groups(P>0.05).Conclusion:The use of toripalimab combined with the GC chemotherapy regimen for advanced urothelial carcinoma can effectively improve clinical outcomes and extend patient survival,with good overall safety.However,attention should be given to preventing adverse reactions such as rash and pneumonia during treatment.展开更多
Objective:To evaluate the dosing,efficacy and safety of the main antileishmanial agents amphotericin B(conventional or liposomal),pentavalent antimonials,miltefosine and paromomycin recommended for the treatment of vi...Objective:To evaluate the dosing,efficacy and safety of the main antileishmanial agents amphotericin B(conventional or liposomal),pentavalent antimonials,miltefosine and paromomycin recommended for the treatment of visceral leishmaniasis in children.Methods:The efficacy and safety of visceral leishmaniasis treatments in children were systematically reviewed using literature from PubMed,Cochrane,clinicaltrials.gov,and Google Scholar,focusing on randomised trials with separate pediatric data(published from 2000-2024).The risk of bias of selected trials was assessed using the revised Cochrane risk-of-bias tool for randomised trials(RoB 2).Reporting was done per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist.Results:Of 1186 records,only 7 were eligible for qualitative synthesis.Three trials exclusively included children.The treatment regimens studied showed high heterogeneity and lacked sufficient data for a meta-analysis.Most trial arms reported efficacies over 94%for children across different regimens.Miltefosine monotherapy showed the highest rate of late treatment failures,highlighting that allometric dosing is crucial to ensure proper drug exposure in children.Safety data for children were available in only three studies with varied reporting systems of adverse events.Although regimens in this review were generally considered to be safe in children,antimonial-related cardiac toxicity remains a threat.Conclusions:This review highlights the need for pediatric-specific trials,clear presentation of pediatric data,and systematic documentation of adverse events to enhance evidence for policy-making and pediatric guideline development.展开更多
BACKGROUND Proper antidepressant use can improve mood and reduce desire to drink alcohol in alcohol-induced-affective-disorder patients.Shugan Jieyu capsules(SJC)have various impacts on the central nervous system,prod...BACKGROUND Proper antidepressant use can improve mood and reduce desire to drink alcohol in alcohol-induced-affective-disorder patients.Shugan Jieyu capsules(SJC)have various impacts on the central nervous system,producing antidepressant effects.Traditional Chinese medicine(including Shugan Jieyu)is highly therapeutic in treating alcohol dependence,with few side-effects.However,research on its combination with Western antidepressants(e.g.,sertraline)to improve patients’depression is insufficient.AIM To evaluate the clinical efficacy and safety of SJC combined with sertraline vs sertraline monotherapy in alcohol-dependent patients with comorbid depression.METHODS We conducted a randomized,double-blind,placebo-controlled trial.Sixty patients(aged 18-65 years)were randomly assigned to two groups(n=30 per group).Primary outcome:Hamilton Depression Rating Scale(HAMD)-17 changes over 6 weeks.Benzodiazepines were permitted for severe insomnia.RESULTS The HAMD-17 score of the study(vs control)group was lower at treatment weeks 2,4,and 6(P<0.05).Regarding intra-group comparisons,the study group’s HAMD score was significantly lower than that before treatment from week 2(P<0.05),while that of the control group was significantly lower than that before treatment from week 4(P<0.05).The study and control groups’total efficacy rates were 90%and 73.3%,respectively,showing a significant difference in efficacy(χ^(2)=4.812,P=0.028).No significant difference was observed in adverse reactions’incidence between the groups at treatment weeks 2,4,and 6(P>0.05).CONCLUSION SJC-sertraline combination therapy accelerates depressive symptom relief(by 2 weeks)and improves response rates(+16.7%)in alcohol-dependent patients,without increasing adverse events.Clinical outcomes suggest potential synergistic mechanisms,though no biomarker analyses were performed.展开更多
BACKGROUND Surgery is the first choice of treatment for patients with colorectal cancer.Traditional open surgery imparts great damage to the body of the patient and can easily cause adverse stress reactions.With the c...BACKGROUND Surgery is the first choice of treatment for patients with colorectal cancer.Traditional open surgery imparts great damage to the body of the patient and can easily cause adverse stress reactions.With the continuous development of medical technology,laparoscopic minimally invasive surgery has shown great advantages for the treatment of patients with celiac disease.AIM To investigate the short-term efficacy of laparoscopic radical surgery and traditional laparotomy for the treatment of colorectal cancer,and the differences in the risk analysis of unplanned reoperation after operation.METHODS As the research subjects,this study selected 100 patients with colorectal cancer who received surgical treatment at the Yulin First Hospital from January 2018 to January 2022.Among them,50 patients who underwent laparoscopic radical resection were selected as the research group and 50 patients who underwent traditional laparotomy were selected as the control group.Data pertaining to clinical indexes,gastrointestinal hormones,nutrition indexes,the levels of inflammatory factors,quality of life,Visual Analog Scale score,and the postoperative complications of the two groups of patients before and after treatment were collected,and the therapeutic effects in the two groups were analyzed and compared.RESULTS Compared with the control group,perioperative bleeding,peristalsis recovery time,and hospital stays were significantly shorter in the research group.After surgery,the levels of gastrin(GAS)and motilin(MTL)were decreased in both groups,and the fluctuation range of GAS and MTL observed in the research group was significantly lower than that recorded in the control group.The hemoglobin(Hb)levels increased after surgery,and the level of Hb in the research group was significantly higher compared with the control group.After the operation,the expression levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein and the total incidence of complications were significantly lower in the research group compared with the control group.One year after the operation,the quality of life of the two groups was greatly improved,with the quality of life in the research group being significantly better.CONCLUSION Laparoscopy was effective for colorectal surgery by reducing the occurrence of complications and inflammatory stress reaction;moreover,the quality of life of patients was significantly improved,which warrants further promotion.展开更多
BACKGROUND First-generation antipsychotics demonstrate certain therapeutic benefits in schizophrenia;however,they often fail to significantly address negative symptoms.Thus,continued exploration is essential to refine...BACKGROUND First-generation antipsychotics demonstrate certain therapeutic benefits in schizophrenia;however,they often fail to significantly address negative symptoms.Thus,continued exploration is essential to refine these treatments.AIM To examine lurasidone plus sulpiride influence on treatment efficacy,psychiatric symptoms,and quality of life in patients with schizophrenia.METHODS A total of 110 patients with schizophrenia,admitted between October 2021 and October 2024,were recruited for this study.The control group(n=50)received sulpiride alone.Conversely,the observation group(n=60)was treated with a combination of lurasidone and sulpiride.A series of assessments were conducted to compare the two groups.These included evaluating treatment efficacy;recording the incidence of adverse events such as fatigue,xerostomia,insomnia,anorexia,and headache;assessing psychiatric symptoms using the positive and negative syndrome scale(PANSS);evaluating cognitive and social functions using the repeatable battery for the assessment of neuropsychological status(RBANS),and the personal and social performance scale(PSP);measuring quality of life using the schizophrenia quality of life scale(SQLS);and analyzing serum markers including interleukin 6(IL-6),IL-17,and prolactin(PRL).RESULTS Overall treatment efficacy was significantly higher in the observation group than in the control group.The total incidence of adverse events was comparable between the two groups.After treatment,the scores for positive symptoms,negative symptoms,and general psychopathological symptoms on the PANSS in the observation group were significantly reduced compared to pretreatment levels,and were also lower than those in the control group.Additionally,RBANS and PSP scores in the observation group significantly increased post-treatment and were notably higher than in the control group.Regarding the quality of life,SQLS scores in the psychosocial,symptoms,and side effects and motivation and energy dimensions in the observation group were significantly lower after treatment than both baseline levels and those in the control group.Furthermore,post-treatment levels of IL-6 and IL-17 in the observation group were significantly reduced and lower than those in the control group,whereas the PRL level was significantly elevated.CONCLUSION The combination of lurasidone and sulpiride can effectively enhance treatment efficacy,alleviate psychiatric symptoms,and improve quality of life in patients with schizophrenia,supporting its broader clinical use.展开更多
BACKGROUND Schizophrenia,a complex group of mental disorders,is primarily managed with antipsychotic medications.The safety and efficacy of different initial doses of lurasidone for acute schizophrenia remain uncertai...BACKGROUND Schizophrenia,a complex group of mental disorders,is primarily managed with antipsychotic medications.The safety and efficacy of different initial doses of lurasidone for acute schizophrenia remain uncertain,particularly concerning discontinuation rates due to adverse events(AEs).AIM To compare the safety of two initial doses of lurasidone for the treatment of acute schizophrenia in Chinese patients.METHODS This 6-week,randomized,open-label,multicenter trial allocated participants to receive either 40 mg/day or 80 mg/day lurasidone initially,with dose adjustment allowed after a one-week fixed-dose period.Safety assessments included the primary endpoint of discontinuation due to AEs,as well as evaluations of AEs,weight changes,and laboratory parameters.Efficacy assessments included responder rates and changes in scores on the Positive and Negative Syndrome Scale(PANSS),Clinical Global Impression-Severity scale,and Calgary Depression Scale for Schizophrenia.RESULTS Among 197 participants,no significant difference was found in discontinuation rate due to AEs between groups(3.03% vs 5.10%,P=0.707).Treatment-emergent AEs were reported in 64.6%and 71.4%of participants in the 40 mg/day and 80 mg/day initiation groups,respectively.Response rates at weeks 1 and 2 showed no statistically significant differences.Both groups demonstrated significant improvements in PANSS total,Clinical Global Impression-Severity,and Calgary Depression Scale for Schizophrenia scores from baseline(all P<0.01).Notably,the 80 mg/day initiation group showed greater improvement in the PANSS positive subscale score at visits 1 and 2 compared to the 40 mg/day initiation group(P<0.05).CONCLUSION Initial doses of 40 mg/day and 80 mg/day lurasidone are safe and effective for acute schizophrenia,with no significant increase in AEs-related discontinuation rate at the higher dose.展开更多
Background:Currently,no worldwide approved therapies exist for adults with neurofibromatosis type 1(NF1)and symptomatic,inoperable plexiform neurofibromas.The KOMET study aimed to evaluate selumetinib(ARRY-142886,AZD6...Background:Currently,no worldwide approved therapies exist for adults with neurofibromatosis type 1(NF1)and symptomatic,inoperable plexiform neurofibromas.The KOMET study aimed to evaluate selumetinib(ARRY-142886,AZD6244)efficacy and safety in this population.Methods:This ongoing multicentre,international,randomised,placebo-controlled,phase 3,parallel,double-blind trial randomly assigned adults with NF1-plexiform neurofibroma 1:1 to 28-day cycles of oral selumetinib 25 mg/m2 twice daily,or placebo with crossover to selumetinib at confirmed radiological progression or the end of cycle 12.展开更多
BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,an...BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.展开更多
To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center...To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.展开更多
BACKGROUND Gastrointestinal angiodysplasias(GIAD)causes recurrent bleeding,and current treatments have limitations.Sirolimus,a mammalian target of rapamycin inhibi-tor,shows promise in inhibiting abnormal angiogenesis...BACKGROUND Gastrointestinal angiodysplasias(GIAD)causes recurrent bleeding,and current treatments have limitations.Sirolimus,a mammalian target of rapamycin inhibi-tor,shows promise in inhibiting abnormal angiogenesis.AIM To evaluate the efficacy and safety of sirolimus in reducing bleeding episodes and improving clinical outcomes in patients with GIAD.METHODS We conducted a self-controlled study with 11 patients taking oral sirolimus.Retrospective data were collected prior to treatment,and prospective data were gathered during the study.Efficacy was assessed primarily by comparing blee-ding episodes before and after sirolimus,with measurements at 3 and 6 months post-administration.The initial dose was 0.8 mg/m^(2)once daily,adjusted to main-tain trough blood concentrations between 5-10 ng/mL.Secondary outcomes included hemoglobin(Hb)levels,blood transfusion volume,and vascular lesions.Safety was monitored by tracking adverse reactions.RESULTS The average number of bleeding episodes decreased significantly from 2.09±1.04 to 1.00±0.75 in the 3 months preceding treatment,and from 3.80±1.93 to 2.00±1.63 in the 6 months preceding treatment.Sirolimus also increased Hb levels,reduced the need for transfusions,and decreased vascular lesions,improving clinical outcomes.All adverse effects were mild and resolved or improved within 1 week to 1 month without stopping sirolimus or needing lipid-lowering treatment.CONCLUSION Sirolimus reduced bleeding and transfusion needs while improving Hb levels in GIAD patients.Although these findings are encouraging,the limited sample size and lack of a control group warrant caution.Future controlled trials with larger populations are needed to validate sirolimus’s potential in GIAD.展开更多
AIM:To evaluate the short-term efficacy and safety of ultrasound cycloplasty(UCP)procedure in Chinese patients with angle-closure glaucoma(ACG),and the mechanisms of its intraocular pressure(IOP)lowering effects.METHO...AIM:To evaluate the short-term efficacy and safety of ultrasound cycloplasty(UCP)procedure in Chinese patients with angle-closure glaucoma(ACG),and the mechanisms of its intraocular pressure(IOP)lowering effects.METHODS:Fifty-six patients(56 eyes)diagnosed with primary and/or secondary ACG were enrolled in this prospective study.Visual acuity,IOP,slit-lamp examinations,structural parameters of anterior segments including anterior chamber depth(ACD),pupillary diameter(PD),anterior chamber area(ACAr),anterior chamber angle(ACAn),and side effects were evaluated.Seven rhesus macaques(Macaca Mulatta)were used for the analyses of IOP lowering effects,including inflammatory reactions,pathohistological evaluation,scanning electron microscopy(SEM),and aqueous outflow pathway via 1%basic fuchsin perfusion.RESULTS:Fifty six eyes of 24 male and 32 female patients with an average age of 58.93±15.97 years old were recruited in primary and secondary ACG affected 31 and 25 eyes,respectively.Clinically,the mean IOP was 17.89±7.93 mm Hg(n=53,53.63%reduction,P<0.001)at 1wk and 22.47±12.00 mm Hg at 12mo(n=16,18.67%reduction,P<0.01)after UCP,compared to the baseline of 39.08±14.75 mm Hg(n=56).Postoperative tolerance was favorable in 94.64%of cases,with visual acuity unchanged or improved in 96.43%of patients.Mild and transient inflammatory reactions were observed post UCP.UBM analysis revealed statistically significant changes in anterior chamber parameters:increased ACD(n=22,P<0.05),enlarged PD(n=22,P<0.05),expanded ACAr(n=16,P<0.01),and widened ACAn(n=19,P<0.05)compared to preoperative measurements.As in normal monkey eyes,IOP was also reduced upon UCP.Mild inflammatory reactions were seen 1-7d post treatment.Hematoxylin and Eosin(H&E)staining showed enlarged spaces among ciliary muscle bundles.Ciliary process stromal edema was evident,but significant loss of two layers of ciliary epitheliums was not seen.SEM confirmed ciliary muscle fibers concentrated.Fuchsin anterior chamber perfusion showed the whole ciliary body staining in UCP group,but only surface staining in controls.CONCLUSION:UCP is efficient and safe to lower the IOP of patients with ACG.Changed anterior chamber structure and increased aqueous humour outflow via uveoscleral pathway may significantly attribute to IOP lowering effects of UCP.展开更多
BACKGROUND Gastric cancer(GC)remains a major global health burden,particularly in East Asia,due to its high incidence,aggressive progression,and poor prognosis in advanced stages.Although surgery is the mainstay of cu...BACKGROUND Gastric cancer(GC)remains a major global health burden,particularly in East Asia,due to its high incidence,aggressive progression,and poor prognosis in advanced stages.Although surgery is the mainstay of curative treatment,outcomes for locally advanced cases remain unsatisfactory despite perioperative chemotherapy.In recent years,immune checkpoint inhibitors,especially anti-PD-1 antibodies like sintilimab,have shown promise in improving survival when combined with chemotherapy.However,the comparative efficacy and safety of SOX plus sintilimab vs established regimens such as P-SOX and SOX alone in the neoadjuvant setting have not been fully explored.AIM To compare the efficacy and safety of three neoadjuvant chemotherapy regimens—SOX combined with sintilimab(SOX+PD-1),albumin-bound paclitaxel plus oxaliplatin and S-1(P-SOX),and SOX—in patients with advanced GC.METHODS A retrospective analysis was conducted on 299 patients with advanced GC who received both neoadjuvant and adjuvant chemotherapy along with standard D2 radical gastrectomy.Among them,81 patients received SOX plus sintilimab,118 received the P-SOX regimen,and 100 received the SOX regimen.All patients were randomly assigned to training(70%)or validation(30%)cohorts using the R software sample function.Short-term efficacy,long-term survival outcomes,and adverse events were assessed across the three groups.Additionally,clinical factors associated with progression-free survival(PFS)were further investigated.RESULTS In terms of short-term efficacy,the SOX+sintilimab group had higher objective response rates[91.4%and 70.4%according to the tumor regression grade(TRG)and Response Evaluation Criteria in Solid Tumors(RECIST)1.1 criteria,respectively]than did the P-SOX(88.1%and 59.3%)and SOX groups(84.0%and 55.0%),although the intergroup differences were not statistically significant(P=0.167).For long-term outcomes,the SOX+sintilimab group demonstrated significantly better OS rates at 1 year(98.8%),18 months(92.6%),2 years(84.0%),and 3 years(48.1%)than did the P-SOX(93.2%,86.4%,71.2%,30.5%)and SOX(91.0%,84.0%,72.0%,29.0%)groups,with the 3-year overall survival(OS)difference being statistically significant(P=0.007).Similarly,PFS rates in the SOX+sintilimab group(1 year:92.6%;18 months:77.8%;2 years:65.4%;3 years:35.8%)were significantly greater than those in the P-SOX(82.2%,68.6%,53.4%,26.3%)and SOX(77.0%,66.0%,43.0%,27.0%)groups,with significant differences at 1 year(P=0.021)and 2 years(P=0.011).In terms of safety,grade 1-2 gastrointestinal reactions,peripheral neuropathy,and alopecia were the main TRAEs across groups.The P-SOX group had a significantly greater incidence of alopecia(54.2%vs 53.0%vs 23.5%,P=0.009)and more cases of grade 2 alopecia(6.8%vs 1.2%),potentially due to the accumulation of triple-agent toxicity.No significant intergroup differences were observed in hematologic toxicity or liver dysfunction(all P>0.05).CONCLUSION Compared with the SOX and P-SOX regimens,the SOX plus sintilimab combination demonstrated significantly improved short-and long-term efficacy with favorable safety,with superior advantages in terms of 2-and 3-year OS and early PFS,suggesting that this combination is a more promising therapeutic option for patients with advanced GC.Patients who achieved good perioperative chemotherapy responses(meeting the TRG and RECIST 1.1 criteria)and had tumor diameters≤2 cm,well-differentiated histology,earlier cTNM stages,and no lymph node metastasis had a better prognosis.展开更多
基金supported by the Innovative Team Project of Ordinary Universities in Guangdong Province(No.2022KCXTD016).
文摘Chemotherapy-induced diarrhea(CID)is a major concern for cancer patients and is associated with significant morbidity and mortality.Currently,the clinical management of CID is limited.The utilization of antidiarrheal medications,such as loperamide and octreotide,is relatively limited because of their unsatisfactory efficacy and adverse effects.In recent years,traditional Chinese medicine(TCM)has attracted great interest because of its beneficial effect in treating CID,which has multitarget and low-toxicity therapeutic characteristics.TCM exhibits remarkable therapeutic potential in the prevention and treatment of CID.It can alleviate and treat CID by regulating chemical drug metabolism,improving the integrity of the intestinal barrier,stimulating proliferation while suppressing the apoptosis of intestinal epithelial cells,ameliorating oxidative stress and inflammation and regulating bile acids and aquaporins.However,large-scale,randomized,double-blind clinical trials of TCM for the treatment of CID are lacking,and most preclinical experiments have not been translated to clinical trials.Accordingly,this review highlights the clinical efficacy and molecular mechanisms of TCM against CID via PubMed,Web of Science and China National Knowledge Infrastructure and proposes that future research on TCM against CID should focus on strengthening the connection from bench to bed,which may help to comprehensively evaluate the therapeutic potential of TCM against CID.
文摘The soothing efficacy of baby moisturizer was evaluated by analyzing the changes of inflammatory cytokines in vitro and human efficacy tests.RAW264.7 cells were induced by Lipopolysaccharide(LPS) to establish a cell inflammation model in vitro,and the inflammatory cytokines of Interleukin-6 (IL-6) and NO were detected to observe the inhibitory effect of baby moisturizer in vitro.The non-toxic concentration of baby moisturizer was detected by MTT assay,the level of IL-6 in RAW264.7 cells supernatant was detected by ELISA kits,and the level of NO in RAW 264.7 cells supernatant was detected by Griess reagent.Dexamethasone was used as the positive control.At the same time,the hydration of the stratum corneum,transepidermal water loss (TEWL),erythema index,the redness of skin (a^(*) value) and the proportion of redness area in facial cheekbones were detected after using the baby moisturizer for 28 days.The experiment results showed that the baby moisturizer at a non-toxic concentration of 0.3 mg/mL,could significantly reduce IL-6 and NO in RAW264.7 cells supernatant,meanwhile it could significantly enhance the hydration of the stratum corneum,and reduce the TEWL,erythema index,the redness of skin (a^(*) value) and the proportion of redness area.In conclusion,the baby moisturizer (0.3 mg/mL) can restrain inflammatory cytokines in vitro and can also significantly improve human facial skin irritation,which can be considered to have soothing efficacy.
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A00806High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023086the Fundamental Research Funds for the Central Public Welfare Research Institutes,No.ZZ17-XRZ-041.
文摘Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.
文摘This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.
基金Supported by National Science and Technology Major Project,No.2024ZD0521002The Innovation Team Project of Traditional Chinese Medicine of Liaoning Province,No.LNZYYCXTD-CCCX-003+1 种基金General Program of the National Natural Science Foundation of China,No.82074296Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China,No.[2022]No.75.
文摘Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.
文摘[Objectives]To systematically evaluate the clinical efficacy of head massage combined with Chinese herbal bath in treating insomnia and analyze its herbal medication patterns.[Methods]Clinical data of 200 chronic insomnia patients treated at the Sleep Disorder Center of Taihe Hospital from January 2020 to December 2024 were retrospectively analyzed.Patients were randomly divided into observation group and control group(n=100 each).The observation group received head massage combined with Chinese herbal bath therapy,while the control group received Chinese herbal bath alone.The Pittsburgh Sleep Quality Index(PSQI)was used for efficacy evaluation,and statistical analysis was performed on the frequency of herbal medications in herbal herbal bath formulas.[Results]The PSQI score improvement in the observation group(8.44±1.87)was significantly better than that in the control group(5.74±1.93)(P<0.01).Herbal formulas for external bath primarily contained mind-calming and heart-nourishing herbs(fried Ziziphi Spinosae Semen,Concha Margaritifera)and heat-clearing herbs(Rhizoma Coptidis,Radix Scutellariae).[Conclusions]The combination of head massage and Chinese herbal bath can significantly improve sleep quality in insomnia patients,demonstrating superior clinical efficacy compared with Chinese herbal bath alone.This combined therapy shows good safety and operability,warranting promotion in primary and specialized medical institutions.
基金Supported by National Undergraduate Training Programs for Innovation and Entrepreneurship(202510580009)Special Project for Promoting the Coordinated Development of Urban and Rural Areas and Regions by Introducing Scientific and Technological Achievements of Guangdong Province into Counties and Towns(2025B0202010051)Project of High-quality Development in Hundred Counties,Thousands Towns and Ten Thousand Villages of Guangdong Provincial Department of Science and Technology:Key Dispatch Project for Rural Science and Technology Commissioners(KTP20240704).
文摘Given that the citrus psyllid is the primary vector of citrus Huanglongbing(HLB),there is an urgent need to control this pest to mitigate the spread of the disease.This paper reviews the current research on two predominant control strategies:chemical control and biological control agents,in managing the citrus psyllid.It emphasizes the mechanisms of action,efficacy,and application advancements of these control methods.Finally,the paper analyzes the principal challenges associated with the sustainable management of citrus psyllids and offers perspectives for future research.
基金Supported by Project of Science and Technology Department of Inner Mongolia Autonomous Region(2019GG125).
文摘[Objectives]To observe the clinical efficacy of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of cervical spondylotic radiculopathy(CSR).[Methods]A total of 120 patients diagnosed with CSR who received treatment at the International Mongolian Hospital of Inner Mongolia between October 2021 and October 2022 were selected and randomly divided into two groups:A test group and a control group,with 60 patients in each group.The patients in the test group received Mongolian medicine silver needle combined with cupping and bloodletting therapy,following the principles of syndrome differentiation in Mongolian medicine.In contrast,the patients in the control group received only the Mongolian medicine silver needle therapy.After treatment,the Mongolian medicine syndrome scores,visual analogue scale(VAS)scores,and total clinical therapeutic effects in the two groups of patients were compared both prior to and following the treatment.[Results]The improvement in VAS and Mongolian medicine syndrome scores in the test group was greater than that in the control group,with a statistically significant difference(P<0.05).The scores of the test group surpassed those of the control group,and this difference was also statistically significant(P<0.05).Furthermore,the overall therapeutic effect in the test group was 93.33%,which was markedly higher than 76.67%observed in the control group(P<0.05).[Conclusions]The therapeutic effect of Mongolian medicine silver needle combined with cupping and bloodletting therapy in the treatment of CSR is remarkable.This approach has demonstrated efficacy in alleviating patient pain and improving the functionality of the cervical vertebrae,thereby warranting clinical promotion and application.
文摘Objective:To analyze the clinical efficacy and safety of toripalimab combined with the GC chemotherapy regimen in the treatment of advanced urothelial carcinoma.Methods:A retrospective study was conducted on 102 patients with advanced urothelial carcinoma treated at our hospital between March 2021 and August 2024.Based on treatment regimens,patients were divided into a chemotherapy group(n=52)and a combination group(n=50).The chemotherapy group received the GC chemotherapy regimen,while the combination group received GC chemotherapy combined with toripalimab.Both groups underwent 4-6 cycles of treatment based on patient tolerance.Clinical efficacy,immune-related factor levels,survival outcomes,and safety were observed and compared.Results:The disease control rate(DCR)and overall response rate(ORR)in the combination group were slightly higher than those in the chemotherapy group,but the differences were not statistically significant(P>0.05).After treatment,levels of IFN-γand IL-2 increased significantly,while VEGF levels decreased significantly in both groups(P<0.05),with superior outcomes observed in the combination group(P<0.05).Follow-up analysis showed progression-free survival(PFS)and median overall survival(OS)in the chemotherapy group were 5.19 and 10.15 months,respectively,compared to 8.24 and 18.23 months in the combination group,with statistically significant differences(P<0.05).During treatment,the incidence of adverse reactions such as rash,immune-related pneumonia,and immune-related diarrhea was higher in the combination group than in the chemotherapy group(P<0.05).However,the incidence of gastrointestinal reactions,fever,and leukopenia did not differ significantly between the two groups(P>0.05).Conclusion:The use of toripalimab combined with the GC chemotherapy regimen for advanced urothelial carcinoma can effectively improve clinical outcomes and extend patient survival,with good overall safety.However,attention should be given to preventing adverse reactions such as rash and pneumonia during treatment.
文摘Objective:To evaluate the dosing,efficacy and safety of the main antileishmanial agents amphotericin B(conventional or liposomal),pentavalent antimonials,miltefosine and paromomycin recommended for the treatment of visceral leishmaniasis in children.Methods:The efficacy and safety of visceral leishmaniasis treatments in children were systematically reviewed using literature from PubMed,Cochrane,clinicaltrials.gov,and Google Scholar,focusing on randomised trials with separate pediatric data(published from 2000-2024).The risk of bias of selected trials was assessed using the revised Cochrane risk-of-bias tool for randomised trials(RoB 2).Reporting was done per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist.Results:Of 1186 records,only 7 were eligible for qualitative synthesis.Three trials exclusively included children.The treatment regimens studied showed high heterogeneity and lacked sufficient data for a meta-analysis.Most trial arms reported efficacies over 94%for children across different regimens.Miltefosine monotherapy showed the highest rate of late treatment failures,highlighting that allometric dosing is crucial to ensure proper drug exposure in children.Safety data for children were available in only three studies with varied reporting systems of adverse events.Although regimens in this review were generally considered to be safe in children,antimonial-related cardiac toxicity remains a threat.Conclusions:This review highlights the need for pediatric-specific trials,clear presentation of pediatric data,and systematic documentation of adverse events to enhance evidence for policy-making and pediatric guideline development.
文摘BACKGROUND Proper antidepressant use can improve mood and reduce desire to drink alcohol in alcohol-induced-affective-disorder patients.Shugan Jieyu capsules(SJC)have various impacts on the central nervous system,producing antidepressant effects.Traditional Chinese medicine(including Shugan Jieyu)is highly therapeutic in treating alcohol dependence,with few side-effects.However,research on its combination with Western antidepressants(e.g.,sertraline)to improve patients’depression is insufficient.AIM To evaluate the clinical efficacy and safety of SJC combined with sertraline vs sertraline monotherapy in alcohol-dependent patients with comorbid depression.METHODS We conducted a randomized,double-blind,placebo-controlled trial.Sixty patients(aged 18-65 years)were randomly assigned to two groups(n=30 per group).Primary outcome:Hamilton Depression Rating Scale(HAMD)-17 changes over 6 weeks.Benzodiazepines were permitted for severe insomnia.RESULTS The HAMD-17 score of the study(vs control)group was lower at treatment weeks 2,4,and 6(P<0.05).Regarding intra-group comparisons,the study group’s HAMD score was significantly lower than that before treatment from week 2(P<0.05),while that of the control group was significantly lower than that before treatment from week 4(P<0.05).The study and control groups’total efficacy rates were 90%and 73.3%,respectively,showing a significant difference in efficacy(χ^(2)=4.812,P=0.028).No significant difference was observed in adverse reactions’incidence between the groups at treatment weeks 2,4,and 6(P>0.05).CONCLUSION SJC-sertraline combination therapy accelerates depressive symptom relief(by 2 weeks)and improves response rates(+16.7%)in alcohol-dependent patients,without increasing adverse events.Clinical outcomes suggest potential synergistic mechanisms,though no biomarker analyses were performed.
文摘BACKGROUND Surgery is the first choice of treatment for patients with colorectal cancer.Traditional open surgery imparts great damage to the body of the patient and can easily cause adverse stress reactions.With the continuous development of medical technology,laparoscopic minimally invasive surgery has shown great advantages for the treatment of patients with celiac disease.AIM To investigate the short-term efficacy of laparoscopic radical surgery and traditional laparotomy for the treatment of colorectal cancer,and the differences in the risk analysis of unplanned reoperation after operation.METHODS As the research subjects,this study selected 100 patients with colorectal cancer who received surgical treatment at the Yulin First Hospital from January 2018 to January 2022.Among them,50 patients who underwent laparoscopic radical resection were selected as the research group and 50 patients who underwent traditional laparotomy were selected as the control group.Data pertaining to clinical indexes,gastrointestinal hormones,nutrition indexes,the levels of inflammatory factors,quality of life,Visual Analog Scale score,and the postoperative complications of the two groups of patients before and after treatment were collected,and the therapeutic effects in the two groups were analyzed and compared.RESULTS Compared with the control group,perioperative bleeding,peristalsis recovery time,and hospital stays were significantly shorter in the research group.After surgery,the levels of gastrin(GAS)and motilin(MTL)were decreased in both groups,and the fluctuation range of GAS and MTL observed in the research group was significantly lower than that recorded in the control group.The hemoglobin(Hb)levels increased after surgery,and the level of Hb in the research group was significantly higher compared with the control group.After the operation,the expression levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein and the total incidence of complications were significantly lower in the research group compared with the control group.One year after the operation,the quality of life of the two groups was greatly improved,with the quality of life in the research group being significantly better.CONCLUSION Laparoscopy was effective for colorectal surgery by reducing the occurrence of complications and inflammatory stress reaction;moreover,the quality of life of patients was significantly improved,which warrants further promotion.
文摘BACKGROUND First-generation antipsychotics demonstrate certain therapeutic benefits in schizophrenia;however,they often fail to significantly address negative symptoms.Thus,continued exploration is essential to refine these treatments.AIM To examine lurasidone plus sulpiride influence on treatment efficacy,psychiatric symptoms,and quality of life in patients with schizophrenia.METHODS A total of 110 patients with schizophrenia,admitted between October 2021 and October 2024,were recruited for this study.The control group(n=50)received sulpiride alone.Conversely,the observation group(n=60)was treated with a combination of lurasidone and sulpiride.A series of assessments were conducted to compare the two groups.These included evaluating treatment efficacy;recording the incidence of adverse events such as fatigue,xerostomia,insomnia,anorexia,and headache;assessing psychiatric symptoms using the positive and negative syndrome scale(PANSS);evaluating cognitive and social functions using the repeatable battery for the assessment of neuropsychological status(RBANS),and the personal and social performance scale(PSP);measuring quality of life using the schizophrenia quality of life scale(SQLS);and analyzing serum markers including interleukin 6(IL-6),IL-17,and prolactin(PRL).RESULTS Overall treatment efficacy was significantly higher in the observation group than in the control group.The total incidence of adverse events was comparable between the two groups.After treatment,the scores for positive symptoms,negative symptoms,and general psychopathological symptoms on the PANSS in the observation group were significantly reduced compared to pretreatment levels,and were also lower than those in the control group.Additionally,RBANS and PSP scores in the observation group significantly increased post-treatment and were notably higher than in the control group.Regarding the quality of life,SQLS scores in the psychosocial,symptoms,and side effects and motivation and energy dimensions in the observation group were significantly lower after treatment than both baseline levels and those in the control group.Furthermore,post-treatment levels of IL-6 and IL-17 in the observation group were significantly reduced and lower than those in the control group,whereas the PRL level was significantly elevated.CONCLUSION The combination of lurasidone and sulpiride can effectively enhance treatment efficacy,alleviate psychiatric symptoms,and improve quality of life in patients with schizophrenia,supporting its broader clinical use.
文摘BACKGROUND Schizophrenia,a complex group of mental disorders,is primarily managed with antipsychotic medications.The safety and efficacy of different initial doses of lurasidone for acute schizophrenia remain uncertain,particularly concerning discontinuation rates due to adverse events(AEs).AIM To compare the safety of two initial doses of lurasidone for the treatment of acute schizophrenia in Chinese patients.METHODS This 6-week,randomized,open-label,multicenter trial allocated participants to receive either 40 mg/day or 80 mg/day lurasidone initially,with dose adjustment allowed after a one-week fixed-dose period.Safety assessments included the primary endpoint of discontinuation due to AEs,as well as evaluations of AEs,weight changes,and laboratory parameters.Efficacy assessments included responder rates and changes in scores on the Positive and Negative Syndrome Scale(PANSS),Clinical Global Impression-Severity scale,and Calgary Depression Scale for Schizophrenia.RESULTS Among 197 participants,no significant difference was found in discontinuation rate due to AEs between groups(3.03% vs 5.10%,P=0.707).Treatment-emergent AEs were reported in 64.6%and 71.4%of participants in the 40 mg/day and 80 mg/day initiation groups,respectively.Response rates at weeks 1 and 2 showed no statistically significant differences.Both groups demonstrated significant improvements in PANSS total,Clinical Global Impression-Severity,and Calgary Depression Scale for Schizophrenia scores from baseline(all P<0.01).Notably,the 80 mg/day initiation group showed greater improvement in the PANSS positive subscale score at visits 1 and 2 compared to the 40 mg/day initiation group(P<0.05).CONCLUSION Initial doses of 40 mg/day and 80 mg/day lurasidone are safe and effective for acute schizophrenia,with no significant increase in AEs-related discontinuation rate at the higher dose.
文摘Background:Currently,no worldwide approved therapies exist for adults with neurofibromatosis type 1(NF1)and symptomatic,inoperable plexiform neurofibromas.The KOMET study aimed to evaluate selumetinib(ARRY-142886,AZD6244)efficacy and safety in this population.Methods:This ongoing multicentre,international,randomised,placebo-controlled,phase 3,parallel,double-blind trial randomly assigned adults with NF1-plexiform neurofibroma 1:1 to 28-day cycles of oral selumetinib 25 mg/m2 twice daily,or placebo with crossover to selumetinib at confirmed radiological progression or the end of cycle 12.
文摘BACKGROUND Urolithiasisposes challenges in patients with chronic kidney disease(CKD),necessitating careful consideration of surgical interventions due to potential complications.AIM To assess the safety,feasibility,and efficacy of surgical interventions for urolithiasis in CKD patients.METHODS Systematic review adhering to PRISMA guidelines.Comprehensive searches of PubMed,Scopus,Cochrane Library,Web of Science,and Embase were conducted for studies published from January 2014 to June 2024.Studies involving adult patients(≥18 years)with CKD undergoing surgical interventions for urolithiasis,including randomized controlled trials,cohort studies,case-control studies,and observational studies.Studies involving pediatric patients,those not specifically addressing CKD patients,review articles,commentaries,and editorials.Despite an extensive search,only six studies met the strict inclusion criteria,reflecting the limited available data on this topic.This limitation has been acknowledged and discussed.RESULTS A total of 6 studies met the inclusion criteria,encompassing a diverse range of surgical interventions such as percutaneous nephrolithotomy(PCNL),ureteroscopy(URS),and extracorporeal shock wave lithotripsy(ESWL).Perioperative and postoperative complications varied across studies,with bleeding,infection,and acute kidney injury being the most common.The risk of complications was higher in patients with advanced CKD.Technical success rates were generally high,but feasibility was influenced by patientspecific factors such as CKD stage and comorbidities.Modifications to standard surgical techniques were often necessary.Stone-free rates and recurrence rates varied,with PCNL generally achieving higher stone-free rates compared to URS and ESWL.Long-term outcomes on renal function were inconsistent,highlighting the need for individualized treatment plans.CONCLUSION Surgical interventions for urolithiasis in CKD patients are associated with significant risks but can be effective in achieving stone clearance and symptom relief.The safety,feasibility,and efficacy of these interventions depend on patient-specific factors,necessitating a tailored approach.Further high-quality studies are needed to develop standardized guidelines and improve clinical outcomes in this complex patient population.
文摘To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.
基金Supported by the Air Force Medical Center Youth Talent Program Project,No.22YXQN034Capital Health Development Research Special Project,No.2020-4-5123Beijing Haidian District Health and Wellness Development Scientific Research Cultivation Program,No.HP2021-03-80803.
文摘BACKGROUND Gastrointestinal angiodysplasias(GIAD)causes recurrent bleeding,and current treatments have limitations.Sirolimus,a mammalian target of rapamycin inhibi-tor,shows promise in inhibiting abnormal angiogenesis.AIM To evaluate the efficacy and safety of sirolimus in reducing bleeding episodes and improving clinical outcomes in patients with GIAD.METHODS We conducted a self-controlled study with 11 patients taking oral sirolimus.Retrospective data were collected prior to treatment,and prospective data were gathered during the study.Efficacy was assessed primarily by comparing blee-ding episodes before and after sirolimus,with measurements at 3 and 6 months post-administration.The initial dose was 0.8 mg/m^(2)once daily,adjusted to main-tain trough blood concentrations between 5-10 ng/mL.Secondary outcomes included hemoglobin(Hb)levels,blood transfusion volume,and vascular lesions.Safety was monitored by tracking adverse reactions.RESULTS The average number of bleeding episodes decreased significantly from 2.09±1.04 to 1.00±0.75 in the 3 months preceding treatment,and from 3.80±1.93 to 2.00±1.63 in the 6 months preceding treatment.Sirolimus also increased Hb levels,reduced the need for transfusions,and decreased vascular lesions,improving clinical outcomes.All adverse effects were mild and resolved or improved within 1 week to 1 month without stopping sirolimus or needing lipid-lowering treatment.CONCLUSION Sirolimus reduced bleeding and transfusion needs while improving Hb levels in GIAD patients.Although these findings are encouraging,the limited sample size and lack of a control group warrant caution.Future controlled trials with larger populations are needed to validate sirolimus’s potential in GIAD.
基金Supported by the National Natural Science Foundation of China(No.82471071)Fujian Provincial Natural Science Foundation of China(No.2023J011580)+1 种基金Natural Science Foundation of Xiamen,China(No.3502Z20227401)Huanhua Scholar Program and the Sichuan Provincial People’s Hospital Postdoctoral Fund(No.2022BH02).
文摘AIM:To evaluate the short-term efficacy and safety of ultrasound cycloplasty(UCP)procedure in Chinese patients with angle-closure glaucoma(ACG),and the mechanisms of its intraocular pressure(IOP)lowering effects.METHODS:Fifty-six patients(56 eyes)diagnosed with primary and/or secondary ACG were enrolled in this prospective study.Visual acuity,IOP,slit-lamp examinations,structural parameters of anterior segments including anterior chamber depth(ACD),pupillary diameter(PD),anterior chamber area(ACAr),anterior chamber angle(ACAn),and side effects were evaluated.Seven rhesus macaques(Macaca Mulatta)were used for the analyses of IOP lowering effects,including inflammatory reactions,pathohistological evaluation,scanning electron microscopy(SEM),and aqueous outflow pathway via 1%basic fuchsin perfusion.RESULTS:Fifty six eyes of 24 male and 32 female patients with an average age of 58.93±15.97 years old were recruited in primary and secondary ACG affected 31 and 25 eyes,respectively.Clinically,the mean IOP was 17.89±7.93 mm Hg(n=53,53.63%reduction,P<0.001)at 1wk and 22.47±12.00 mm Hg at 12mo(n=16,18.67%reduction,P<0.01)after UCP,compared to the baseline of 39.08±14.75 mm Hg(n=56).Postoperative tolerance was favorable in 94.64%of cases,with visual acuity unchanged or improved in 96.43%of patients.Mild and transient inflammatory reactions were observed post UCP.UBM analysis revealed statistically significant changes in anterior chamber parameters:increased ACD(n=22,P<0.05),enlarged PD(n=22,P<0.05),expanded ACAr(n=16,P<0.01),and widened ACAn(n=19,P<0.05)compared to preoperative measurements.As in normal monkey eyes,IOP was also reduced upon UCP.Mild inflammatory reactions were seen 1-7d post treatment.Hematoxylin and Eosin(H&E)staining showed enlarged spaces among ciliary muscle bundles.Ciliary process stromal edema was evident,but significant loss of two layers of ciliary epitheliums was not seen.SEM confirmed ciliary muscle fibers concentrated.Fuchsin anterior chamber perfusion showed the whole ciliary body staining in UCP group,but only surface staining in controls.CONCLUSION:UCP is efficient and safe to lower the IOP of patients with ACG.Changed anterior chamber structure and increased aqueous humour outflow via uveoscleral pathway may significantly attribute to IOP lowering effects of UCP.
基金Supported by Qinghai Provincial Science and Technology Plan,No.2023-ZJ-787.
文摘BACKGROUND Gastric cancer(GC)remains a major global health burden,particularly in East Asia,due to its high incidence,aggressive progression,and poor prognosis in advanced stages.Although surgery is the mainstay of curative treatment,outcomes for locally advanced cases remain unsatisfactory despite perioperative chemotherapy.In recent years,immune checkpoint inhibitors,especially anti-PD-1 antibodies like sintilimab,have shown promise in improving survival when combined with chemotherapy.However,the comparative efficacy and safety of SOX plus sintilimab vs established regimens such as P-SOX and SOX alone in the neoadjuvant setting have not been fully explored.AIM To compare the efficacy and safety of three neoadjuvant chemotherapy regimens—SOX combined with sintilimab(SOX+PD-1),albumin-bound paclitaxel plus oxaliplatin and S-1(P-SOX),and SOX—in patients with advanced GC.METHODS A retrospective analysis was conducted on 299 patients with advanced GC who received both neoadjuvant and adjuvant chemotherapy along with standard D2 radical gastrectomy.Among them,81 patients received SOX plus sintilimab,118 received the P-SOX regimen,and 100 received the SOX regimen.All patients were randomly assigned to training(70%)or validation(30%)cohorts using the R software sample function.Short-term efficacy,long-term survival outcomes,and adverse events were assessed across the three groups.Additionally,clinical factors associated with progression-free survival(PFS)were further investigated.RESULTS In terms of short-term efficacy,the SOX+sintilimab group had higher objective response rates[91.4%and 70.4%according to the tumor regression grade(TRG)and Response Evaluation Criteria in Solid Tumors(RECIST)1.1 criteria,respectively]than did the P-SOX(88.1%and 59.3%)and SOX groups(84.0%and 55.0%),although the intergroup differences were not statistically significant(P=0.167).For long-term outcomes,the SOX+sintilimab group demonstrated significantly better OS rates at 1 year(98.8%),18 months(92.6%),2 years(84.0%),and 3 years(48.1%)than did the P-SOX(93.2%,86.4%,71.2%,30.5%)and SOX(91.0%,84.0%,72.0%,29.0%)groups,with the 3-year overall survival(OS)difference being statistically significant(P=0.007).Similarly,PFS rates in the SOX+sintilimab group(1 year:92.6%;18 months:77.8%;2 years:65.4%;3 years:35.8%)were significantly greater than those in the P-SOX(82.2%,68.6%,53.4%,26.3%)and SOX(77.0%,66.0%,43.0%,27.0%)groups,with significant differences at 1 year(P=0.021)and 2 years(P=0.011).In terms of safety,grade 1-2 gastrointestinal reactions,peripheral neuropathy,and alopecia were the main TRAEs across groups.The P-SOX group had a significantly greater incidence of alopecia(54.2%vs 53.0%vs 23.5%,P=0.009)and more cases of grade 2 alopecia(6.8%vs 1.2%),potentially due to the accumulation of triple-agent toxicity.No significant intergroup differences were observed in hematologic toxicity or liver dysfunction(all P>0.05).CONCLUSION Compared with the SOX and P-SOX regimens,the SOX plus sintilimab combination demonstrated significantly improved short-and long-term efficacy with favorable safety,with superior advantages in terms of 2-and 3-year OS and early PFS,suggesting that this combination is a more promising therapeutic option for patients with advanced GC.Patients who achieved good perioperative chemotherapy responses(meeting the TRG and RECIST 1.1 criteria)and had tumor diameters≤2 cm,well-differentiated histology,earlier cTNM stages,and no lymph node metastasis had a better prognosis.
