BACKGROUND The accuracy of blind intra-articular injections in the shoulder is rather low.Inaccurate injections tend to lead to poorer treatment outcomes.The“Delaware posterior bone touch technique”has shown higher ...BACKGROUND The accuracy of blind intra-articular injections in the shoulder is rather low.Inaccurate injections tend to lead to poorer treatment outcomes.The“Delaware posterior bone touch technique”has shown higher accuracy in young,slender,healthy volunteers than the classical“Cyriax technique”.AIM To investigate whether the Delaware technique would also be more accurate in older patients with capsulitis.METHODS We analyzed the files of 100 consecutive patients with capsulitis who were treated with an intra-articular injection containing a mixture of triamcinolone,lidocaine,and air.After the injection,the shoulder was moved to determine whether a squishing sound could be produced.The squishing sound was interpreted as an accurate injection.The scores with the new Delaware technique were compared against those with the Cyriax technique in a previous study.RESULTS Squishing was heard after 87%of the injections.This was 13%(10%points)more than the 77%in the previous study(P=0.004).CONCLUSION The Delaware technique was significantly more accurate than the Cyriax technique also in middle aged patients with capsulitis.We hypothesize that the difference is caused by a lower risk that a part of the opening of the needle is still outside the capsule.展开更多
BACKGROUND Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion(CSII)require a lower dose of insulin than those treated with multiple daily injections(MDIs).Howeve...BACKGROUND Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion(CSII)require a lower dose of insulin than those treated with multiple daily injections(MDIs).However,it is unclear whether this is also the case for patients with type 2 diabetes mellitus(T2DM).AIM To compare insulin dosage requirements between CSII and MDI in T2DM,iden-tifying influencing factors associated with both therapeutic modalities.METHODS A total of 954 patients with T2DM were divided into two groups:CSII and MDI groups.The total daily insulin dose(TDD),TDD per kilogram per day(TDD/kg),and ratio of total basal insulin dose to TDD(%TBa)required to achieve the target blood glucose levels were compared between the two groups.In addition,factors affecting insulin dosage were analyzed in both groups of patients.RESULTS Compared to the CSII group,the MDI group required a higher TDD[median(interquartile)]:30.00(24.00,38.00)U/day vs 26.40(21.60,32.40)U/day;P<0.01,TDD/kg and%TBa.In the MDI group and CSII groups,an increase in TDD was independently associated with an increase in body mass index(BMI),waist circumference(WC),fasting plasma glucose(FPG),and glycated hemoglobin(HbA1c).The pathophysiology of type 2 diabetes mellitus(T2DM)mainly involves insulin resistance and progressiveβ-cell failure,which leads to increased blood glucose levels(hyperglycemia)[1-3].Treatment for T2DM includes antidiabetic medications and insulin therapy[4,5].Patients with T2DM withβ-cell failure usually require insulin therapy[6-8].Continuous subcutaneous insulin infusion(CSII)and multiple daily injections(MDIs)are two major insulin therapies for controlling hyperglycemia in these patients.However,excessive insulin therapies may cause problems such as hypoglycemia,weight gain,and iatrogenic hyperinsulinemia[9].Therefore,attention should be paid to the dosage of insulin used.The establishment of insulin regimens for CSII and MDI therapies is primarily guided by physicians’empirical judgment.To date,there have been few clear guidelines or recommendations on the appropriate insulin dose during CSII and MDI treatment for T2DM[10].Yang et al[11]studied insulin doses and related factors in the CSII treatment of patients with T2DM[12].However,these studies did not cover the dose setting and related factors in MDI treatment.Previous studies have shown that patients with type 1 diabetes mellitus treated with CSII require less insulin than those treated with MDIs[13-15].However,it is unclear whether patients with T2DM on CSII also require less insulin than patients on MDI.Therefore,the present study determined the difference in insulin dosages between CSII and MDI therapies and evaluated the related factors in patients with T2DM.It also systematically analyzed the insulin dose characteristics of MDI and CSII in 954 hospitalized patients with T2DM,aiming to optimize the insulin dosage regimen and provide clinical references for guiding the application of CSII and MDI in patients with T2DM.展开更多
BACKGROUND Intra-articular hip injections(IAHIs)are commonly used for diagnostic and therapeutic purposes but are often associated with patient anxiety and fear.The disparity between anticipated and experienced pain d...BACKGROUND Intra-articular hip injections(IAHIs)are commonly used for diagnostic and therapeutic purposes but are often associated with patient anxiety and fear.The disparity between anticipated and experienced pain during IAHIs and the role of preinjection local anesthesia in pain modulation remains unclear.AIM To investigate the difference between anticipated and experienced pain during IAHIs and the impact of pre-injection local anesthesia.METHODS This prospective study enrolled 60 patients undergoing IAHI,30 receiving pre-injection superficial local anesthesia and 30 serving as a control group without pre-injection local anesthesia.Pain levels were assessed using numeric rating scales.RESULTS Patients significantly overestimated anticipated pain compared to experienced pain(6.43±2.48 vs 3.68±2.37,P<0.001).Pre-injection local anesthesia did not significantly reduce experienced pain(3.19±2.38 vs 4.20±2.29,P=0.130).CONCLUSION Patients overestimate anticipated pain during IAHIs.Pre-injection local anesthesia does not reduce experienced pain.展开更多
BACKGROUND Sub-acromial injections are a therapeutic option for rotator cuff injuries;however,evidence regarding the most effective drug in this context is unclear,which needs to be investigated.AIM To evaluate the ef...BACKGROUND Sub-acromial injections are a therapeutic option for rotator cuff injuries;however,evidence regarding the most effective drug in this context is unclear,which needs to be investigated.AIM To evaluate the effectiveness of various sub-acromial injections for rotator cuff injuries.METHODS We conducted a systematic review and pair-wise and network meta-analyses of randomized clinical trials(RCTs)comparing sub-acromial injections for rotator cuff injuries.The interventions evaluated were hyaluronic acid(HA),platelet-rich plasma(PRP),prolotherapy,and corticosteroids.The outcomes of interest were pain and functional improvement,which were evaluated with standardized scores.The Risk of Bias 2 tool and the Grading of Recommendations,Assessment,Development and Evaluation methodology were used to assess data quality.RESULTS Twenty RCTs,comprising 1479 participants,were included.In the short term,HA achieved the best outcomes[pain mean difference(MD)=-1.48,95%confidence interval(CI)-2.37 to-0.59;function MD=10.18,95%CI:4.96-15.41].In the medium term,HA,PRP,HA+PRP,and corticosteroids were not superior to placebo in improving pain.Based on function,HA+PRP was superior to placebo,corticosteroids,and PRP(MD=26.72;95%CI:8.02-45.41).In the long term,HA,PRP,and corticosteroids were not superior to placebo in reducing pain.However,based on function,HA+PRP,PRP,and HA were superior to placebo,and HA+PRP had the best result(MD=36.64;95%CI:31.66-33.62).CONCLUSION HA provides satisfactory short-term results,while HA with PRP demonstrates functional improvement in the medium and long terms.However,no intervention maintained the pain-relief effect on>3-month follow-up.展开更多
Background: Total joint replacement (TJR) patients can suffer from tendinitis, bursitis or other inflammatory conditions that are generally treated by cortisone (corticosteroid) injections. Such injections rarely caus...Background: Total joint replacement (TJR) patients can suffer from tendinitis, bursitis or other inflammatory conditions that are generally treated by cortisone (corticosteroid) injections. Such injections rarely cause complications in the general public, but have resulted in severe implant infections in some patients with joint replacements. The purpose of this study is to review the literature involving joint replacement infections after cortisone injections and present ozone as an alternative to cortisone in a series of joint replacement patients with periarticular inflammatory conditions. Methods: There were 26 combined patients with either total hip replacement (THR), total knee replacement (TKR), total ankle replacement (TAR), or resurfacing shoulder replacement (SR) that developed tendonitis, bursitis or inflammatory problems related to their respective joint arthroplasties. Rather than use cortisone, they were given prolozone injections into the inflammatory regions to relieve them of their pain and dysfunction. This injection was followed by an ice pack for one hour and a return to normal function thereafter. Results: All THR, TKR, SR and TAR pathologies were improved or asymptomatic after one or a series of prolozone injections into the area of inflammation. No cortisone injections were used and no infections were encountered. Conclusions: Prolozone injection therapy is an effective treatment for post-operative inflammatory conditions following total joint replacement. Patients find relief of inflammation symptoms, similar to steroid injections, without the risk of infection or tissue breakdown. Prolozone injection therapy can be useful when conventional injection treatment fails, or is contraindicated.展开更多
Botulinum toxin(BT)injections to the glabellar region are emerging as a promising investigational treatment for multiple mental health conditions.By paralyzing the muscles involved in frowning,this intervention is pos...Botulinum toxin(BT)injections to the glabellar region are emerging as a promising investigational treatment for multiple mental health conditions.By paralyzing the muscles involved in frowning,this intervention is postulated by the facial feedback hypothesis to reduce the intensity of negative affective states and has a growing body of evidence for treating major depression.However,applications to other psychiatric conditions have been relatively unexplored.This is the first study to our knowledge to examine the effect of glabellar BT on generalized anxiety.By tracking GAD-7 scores of a cosmetic population before and after receipt of glabellar BT,we observed a statistically significant decrease of anxious symptoms among patients who entered the study with a baseline level of clinical anxiety.Though more research is needed,our results suggest glabellar BT has the potential to improve symptoms of mild to moderate generalized anxiety.展开更多
Based on the EAST equilibrium,the effects of boron(B)and neon(Ne)injected at different locations on the target heat load,and the distributions of B and Ne particles were investigated by transport code SOLPS-ITER.It wa...Based on the EAST equilibrium,the effects of boron(B)and neon(Ne)injected at different locations on the target heat load,and the distributions of B and Ne particles were investigated by transport code SOLPS-ITER.It was found that the B injection was more sensitive to the injection location for heat flux control than impurity Ne.The high electron and ion densities near the inner target in the discharge with impurity B injected from over X-point(R_(1))led to plasma detachment only at the inner target,and the localized B ions in the cases with injection from outer target location(R_(2))and upstream location(R_(3))led to far-SOL detachment at the outer target,but not at the inner target.In contrast,for Ne,the spatial distributions of Ne ions and electrons were found to be similar in all the cases at the three injection locations,and the detached plasma was achieved at the inner target and the electron temperature was reduced at the outer target.For locations R_(2) and R_(3),impurity B showed a more pronounced effect on the heat flux at the far-SOL of the outer target.Further analysis indicated that Ne atoms came mainly from the recycling sources,whereas B atoms came mainly from injection,and that their distinct atomic distributions resulted from the difference in the ionization threshold and ionization mean free path.In addition,the radiation proportion of B in the divertor region was larger than that of Ne when the total radiation power was similar,which suggests that B has less influence on the core region.展开更多
Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men worldwide.In the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining attention.The ...Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men worldwide.In the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining attention.The current literature shows dataon the efficacy of intraplaque injections of hyaluronic acid(HA)mainly in acute-phase PD.However,data on injections of HA instable-phase PD are lacking.Data for this retrospective study were derived from a prospectively maintained database of privatepatients presenting at a private medical practice affiliated to the University of Naples“Federico II”(Naples,Italy)with stable-phasePD between January 2020 and March 2023.Patients underwent a standard protocol of three injections,each administered at atwo-week interval.During the intervals,patients performed vacuum device therapy,penile stretching,and modeling exercises.Allpatients compiled the Peyronie’s Disease Questionnaire(PDQ)and Global Assessment of Peyronie’s Disease(GAPD)at baselineand 2 weeks after the third injection.A penile Doppler ultrasound was performed 2 weeks after the last injection to record thefinal curvature.Overall,we recruited 62 patients with stable-phase PD and a mean(±standard deviation[s.d.])curvature of52.7°(±9.7°).After 6 weeks,eight(12.9%)patients did not experience any curvature improvement.The remaining 54 patientshad a final mean(±s.d.)curvature of 40.3°(±9.1°)with P<0.001,compared to that before treatment.We found improvement inall PDQ domains(all P≤0.01),and 50(80.6%)patients reported subjective improvement of the penile curvature according to theGAPD.In conclusion,we demonstrated that after three injections of HA administered according to the adopted protocol,patientswith stable-phase PD could experience significant improvements in penile curvature,and physical and psychological consequencesof the disease without significantly relevant side effects.展开更多
●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the corre...●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time IVAI.The correlation of immediate IOP increase and VR rates with the four background diseases was investigated.Moreover,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were evaluated.Further,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background diseases.The immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background diseases.The immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR rate.Further,age and axial length have no correlation on immediate IOP increase and VR rate.展开更多
BACKGROUND Intra-articular glenohumeral joint injections are essential procedures for treating various shoulder disorders. Fluoroscopy-guided injections have been extensively used;however, they pose a risk of radiatio...BACKGROUND Intra-articular glenohumeral joint injections are essential procedures for treating various shoulder disorders. Fluoroscopy-guided injections have been extensively used;however, they pose a risk of radiation exposure and are expensive and timeconsuming. Recently, it has been suggested that ultrasound-guided injections are accurate and cost effective procedures.AIM To evaluate the accuracy of ultrasound-guided glenohumeral injections using a posterior approach that is confirmed using magnetic resonance arthrography(MRA).METHODS The study included 179 shoulders of patients with recurrent anterior instability(150 patients;103 and 76 right and left shoulders, respectively;160 males and 19 females;average age = 20.5 years;age range: 14-63 years) who underwent MRA for preoperative diagnosis. They were injected with 12 m L lidocaine(1%) using the ultrasound-guided posterior approach and then underwent magnetic resonance imaging. Two shoulder surgeons, except for the injector, evaluated the transverse relaxation(T2)-weighted images of axial planes and classified the intraarticular condition of injected contrast into three groups based on one of the three following scenarios: no leakage, injection into the glenohumeral joint without leakage;minor leakage, practical intra-articular injection with some leakage outside the posterior rotator cuffs;and major leakage, inaccurate injection with mass leakage without any contrast into the joint. The inter-rater reliability between two assessors was also evaluated by calculating Cohen’s kappa coefficient. The learning curve was assessed regarding the inaccurate injection rate by analyzing Spearman’s rank correlation coefficient.RESULTS Of the 179 injections, 163 shoulders(91.0%) had no leakage, 10 shoulders(5.6%) had minor leakage, and six shoulders(3.4%) had major leakage. In total, 173 shoulders(96.6%) were intraarticularly injected;thus, we could detect anterior labrum and capsular pathologies. Regarding the inter-rater reliability, the kappa coefficient was 0.925, indicating consistency in the evaluations by both examiners. Regression analysis of the inaccurate injection rate for assessingtechnical learning showed a logarithmic curve with a downward trend(R;= 0.887, P < 0.001). Three(50%) of the six inaccurate injections classified into “major leakage” were observed in the first 30 injections, indicating that the accurate injection showed a leaning effect.CONCLUSION Ultrasound-guided intra-articular glenohumeral injections using a posterior approach had high accuracy;however, injection accuracy depends on clinical experience.展开更多
The aim of this study was to explore the neuroprotective effect and mechanism of XingNaoJing injections(XNJ) on cerebral ischemia injury and blood-brain barrier(BBB) disruption. Middle cerebral artery occlusion(MCAO) ...The aim of this study was to explore the neuroprotective effect and mechanism of XingNaoJing injections(XNJ) on cerebral ischemia injury and blood-brain barrier(BBB) disruption. Middle cerebral artery occlusion(MCAO) method was applicated to establish the model of cerebral ischemia/reperfusion(I/R) injury in rats. BBB permeability after I/R injury was assessed with the leaking amount of Evans Blue and the expression of occludin and ZO-1. The expression of NOD-like receptor family, pyrin domain containing(NLRP3) was checked to explore the inhibition of inflammation by XNJ. The results showed that XNJ could significantly increase the survival percent, decrease the infarct area and ameliorate neurological deficits and brain damage after I/R injury. Leaking amount of Evans Blue was reduced by XNJ, and the expression of tight junction protein, occludin and ZO-1 was also up-regulated by XNJ, which showed a role of protection on BBB disruption. The expression of NLRP3 was inhibited after exposure of XNJ, which was associated with inhibition of the inflammatory response. In summary, XNJ could suppress NLRP3 inflammasomes and improve BBB disruption and brain damage in rats after cerebral I/R injury, which provided a beneficial insight to further explore XNJ.展开更多
Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeli...Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.展开更多
OBJECTIVE:To assess the clinical efficacy and safety of ginkgo injections(GIs)combined with conventional treatment(CT)against angina pectoris(AP)due to coronary heart disease(CH D).METHODS:Randomized controlled trials...OBJECTIVE:To assess the clinical efficacy and safety of ginkgo injections(GIs)combined with conventional treatment(CT)against angina pectoris(AP)due to coronary heart disease(CH D).METHODS:Randomized controlled trials(RCTs)that used GIs to treat AP were searched in SinoMed,PubMed,China National Knowledge Infrastructure Database,Chinese Scientific Journals Database,Wanfang Database,Embase and Cochrane Library until March 2017.The Cochrane "risk of bias" method was used to evaluate the methodological quality of RCTs.Data were analyzed using Stata v13.1 and WinBUGS v1.4.3.RESULTS:A total of 73 RCTs involving 7621 patients were included.A Bayesian network Meta-analysis of RCTs was undertaken,and the advantages of four types of Gl-supplemented CT in AP treatment were determined.CONCLUSION:Gl-assisted CT was more effective against AP than CT alone.However,based on the limitations of the study,additional high-quality RCTs are required to confirm our findings.展开更多
OBJECTIVE: To address the optimal Chinese herbal injections(CHIs) against liver cancer, the present network Meta-analysis is designed to investigate the comparative efficacy and safety of different CHIs.METHODS: Sever...OBJECTIVE: To address the optimal Chinese herbal injections(CHIs) against liver cancer, the present network Meta-analysis is designed to investigate the comparative efficacy and safety of different CHIs.METHODS: Several electronic databases were searched up to June 1 st, 2017. The quality assessment was conducted and network Meta-analysis was performed to compare the efficacy and safety of different CHIs plus transcatheter hepatic arterial chemoembolization(TACE). Primary outcomes were 1-year and 2-year survival rate, the secondary outcomes includes the clinical effective rate, performance status and the adverse reactions(ADRs). Data analysis was applied Stata 13.0 and Win BUGS 1.4 software.RESULTS: A total of 105 randomized controlled trials(RCTs) were identified for inclusion in this analysis, with data for 7683 patients and 13 CHIs. The results suggested that Javanica oil emulsion,Huachansu injection plus TACE were more favorable for 1-year and 2-year survival rate than other CHIs. Kanglaite, Astragalus polysaccharide injection plus TACE showed superiority in the clinical effective rate and performance status over other CHIs.And Shenmai injection plus TACE was superior to reducing ADRs than other CHIs for patients with liver cancer.CONCLUSION: Our findings indicated that receiving CHIs combined with TACE may have therapeutic benefits for patients with liver cancer in improving survival rate, clinical effective rate, the performance status and alleviating the ADRs.展开更多
OBJECTIVE： To ascertain if it is effective to use extradural injections and manual repositioning of the spine to treat megalgia caused by cervical spondy- Iotic radiculopathy （CSR）. METHODS： Patients with megalgia...OBJECTIVE： To ascertain if it is effective to use extradural injections and manual repositioning of the spine to treat megalgia caused by cervical spondy- Iotic radiculopathy （CSR）. METHODS： Patients with megalgia caused by CSR were divided into a treatment group （n=46） treated by extradural injection and manual repositioning of the spine and a control group （n=46） treated by a conventional method. RESULTS： The prevalence of cure was 58.69% and the total prevalence of effective cure in the treatment group was 97.83% and was 23.91% and 78.26%, respectively, in the control group： this difference between the two groups was significant （P〈 0.05）. CONCLUSION： Treatment of megalgia caused by CSR by extradural injections and manual repositioning of the spine has a good curative effect with rapid analgesia and short therapeutic course.展开更多
The present study was designed to determine the relationships between the performance of ethanol precipitation and seven process parameters in the ethanol precipitation process of Re Du Ning Injections,including conce...The present study was designed to determine the relationships between the performance of ethanol precipitation and seven process parameters in the ethanol precipitation process of Re Du Ning Injections,including concentrate density,concentrate temperature,ethanol content,flow rate and stir rate in the addition of ethanol,precipitation time,and precipitation temperature.Under the experimental and simulated production conditions,a series of precipitated resultants were prepared by changing these variables one by one,and then examined by HPLC fingerprint analyses.Different from the traditional evaluation model based on single or a few constituents,the fingerprint data of every parameter fluctuation test was processed with Principal Component Analysis(PCA)to comprehensively assess the performance of ethanol precipitation.Our results showed that concentrate density,ethanol content,and precipitation time were the most important parameters that influence the recovery of active compounds in precipitation resultants.The present study would provide some reference for pharmaceutical scientists engaged in research on pharmaceutical process optimization and help pharmaceutical enterprises adapt a scientific and reasonable cost-effective approach to ensure the batch-to-batch quality consistency of the final products.展开更多
Spinal pain(SP)is a common condition that has a major negative impact on a patient’s quality of life.Recent developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical...Spinal pain(SP)is a common condition that has a major negative impact on a patient’s quality of life.Recent developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical practice.This clinical expert consensus describes the purpose,significance,implementation methods,indications,contraindications,and techniques of ultrasound-guided injections.This consensus offers a practical reference point for physicians to implement successfully ultrasound-guided injections in the treatment of chronic SP.展开更多
Relativistic electron injections are one of the mechanisms of relativistic(≥0.5 MeV) electron enhancements in the Earth’s outer radiation belt. In this study, we present a statistical observation of 600 keV electron...Relativistic electron injections are one of the mechanisms of relativistic(≥0.5 MeV) electron enhancements in the Earth’s outer radiation belt. In this study, we present a statistical observation of 600 keV electron injections in the outer radiation belt by using data from the Van Allen Probes. On the basis of the characteristics of different injections, 600 keV electron injections in the outer radiation belt were divided into pulsed electron injections and nonpulsed electron injections. The 600 keV electron injections were observed at 4.5 < L <6.4 under the geomagnetic conditions of 450 nT < AE < 1,450 nT. An L of ~4.5 is an inward limit for 600 keV electron injections. Before the electron injections, a flux negative L shell gradient for ≤0.6 MeV electrons or low electron fluxes in the injected region were observed. For600 keV electron injections at different L shells, the source populations from the Earth’s plasma sheet were different. For 600 keV electron injections at higher L shells, the source populations were higher energy electrons(~200 keV at X ~–9 R_(E)), whereas the source populations for 600 keV electron injections at lower L shells were lower energy electrons(~80 keV at X ~–9 R_(E)). These results are important to further our understanding of electron injections and rapid enhancements of 600 keV electrons in the Earth’s outer radiation belt.展开更多
AIM: To assess the effect of lens status on sustained intraocular pressure(IOP) elevation in patients treated intravitreally with anti-vascular endothelial growth factor(VEGF) agents. METHODS: Data were retrospectivel...AIM: To assess the effect of lens status on sustained intraocular pressure(IOP) elevation in patients treated intravitreally with anti-vascular endothelial growth factor(VEGF) agents. METHODS: Data were retrospectively collected for all patients treated with intravitreal injections of anti-VEGF medication at a tertiary medical center in July 2015. Findings were analyzed by lens status during 6 months' follow-up. The main outcome measure was a sustained increase in IOP(≥21 mm Hg or change of ≥6 mm Hg from baseline on ≥2 consecutive visits, or addition of a new IOPlowering medication during follow-up). RESULTS: A total of 119 eyes of 100 patients met the study criteria: 40 phakic, 40 pseudophakic, and 39 pseudophakic after Nd:YAG capsulotomy. The rate of sustained IOP elevation was significantly higher in the postcapsulotomy group(23.1%) than in the phakic/pseudophakic groups(8.1%;P=0.032), with no statistically significant differences among the 3 groups in mean number of injections, either total(P=0.82) or by type of anti-VEGF mediation(bevacizumab: P=0.19;ranibizumab: P=0.13), or mean follow-up time(P=0.70). CONCLUSION: Nd:YAG capsulotomy appears to be a risk factor for sustained IOP elevation in patients receiving intravitreal anti-VEGF injections. This finding has important implications given the growing use of anti-VEGF treatment and the irreversible effects of elevated IOP.展开更多
Aim： To assess the behavior of patients with diabetes mellitus （DM） and erectile dysfunction （ED） during 10 consecutive years of treatment with self-injection of vasoactive drugs. Methods： Thirty-eight diabetic ...Aim： To assess the behavior of patients with diabetes mellitus （DM） and erectile dysfunction （ED） during 10 consecutive years of treatment with self-injection of vasoactive drugs. Methods： Thirty-eight diabetic men, including 12 with type Ⅰ and 26 with type Ⅱ diabetes, were followed up regularly for 10 years after they began self-injecting for severe ED. Real time rigidity assessment was used for the objective determination of the initial dosage and then doses were regulated in order to introduce an erection suitable for penetration and maintenance of erection for approximately 30 min. Patients were followed up every two months, and doses were increased only when the treatment response was not satisfactory. Results： The number of injections used per year by the patients was reduced each year （mean numbers： 50 in the first year and 22.5 in the 10th） and treatment shifted towards stronger therapeutic modalities （mixtures of vasoactive drugs instead of prostaglandin E1 alone）. Type Ⅰ diabetic men were standardized to a level of treatment as early as 5 years after the initiation of treatment. That level was finally reached by type Ⅱ patients after another 4-5 years. Conclusion： Treatment with self-injections of vasoactive drugs in diabetic men with severe El） is a safe and effective alternative in the long term. Diabetic men of both types show the same preferences in quality and quantity of treatment after 10 years. The key point for maintenance in treatment is the adjustment of the therapeutic method and dosage to optimal levels for satisfactory erections. （Asian J Androl 2006 Mar; 8： 219-224）展开更多
文摘BACKGROUND The accuracy of blind intra-articular injections in the shoulder is rather low.Inaccurate injections tend to lead to poorer treatment outcomes.The“Delaware posterior bone touch technique”has shown higher accuracy in young,slender,healthy volunteers than the classical“Cyriax technique”.AIM To investigate whether the Delaware technique would also be more accurate in older patients with capsulitis.METHODS We analyzed the files of 100 consecutive patients with capsulitis who were treated with an intra-articular injection containing a mixture of triamcinolone,lidocaine,and air.After the injection,the shoulder was moved to determine whether a squishing sound could be produced.The squishing sound was interpreted as an accurate injection.The scores with the new Delaware technique were compared against those with the Cyriax technique in a previous study.RESULTS Squishing was heard after 87%of the injections.This was 13%(10%points)more than the 77%in the previous study(P=0.004).CONCLUSION The Delaware technique was significantly more accurate than the Cyriax technique also in middle aged patients with capsulitis.We hypothesize that the difference is caused by a lower risk that a part of the opening of the needle is still outside the capsule.
基金Supported by the National Key R and D Program of China,No.2021YFC2501700 and No.2021YFC2501705and the National Natural Science Foundation of China,No.82171580 and No.81672646.
文摘BACKGROUND Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion(CSII)require a lower dose of insulin than those treated with multiple daily injections(MDIs).However,it is unclear whether this is also the case for patients with type 2 diabetes mellitus(T2DM).AIM To compare insulin dosage requirements between CSII and MDI in T2DM,iden-tifying influencing factors associated with both therapeutic modalities.METHODS A total of 954 patients with T2DM were divided into two groups:CSII and MDI groups.The total daily insulin dose(TDD),TDD per kilogram per day(TDD/kg),and ratio of total basal insulin dose to TDD(%TBa)required to achieve the target blood glucose levels were compared between the two groups.In addition,factors affecting insulin dosage were analyzed in both groups of patients.RESULTS Compared to the CSII group,the MDI group required a higher TDD[median(interquartile)]:30.00(24.00,38.00)U/day vs 26.40(21.60,32.40)U/day;P<0.01,TDD/kg and%TBa.In the MDI group and CSII groups,an increase in TDD was independently associated with an increase in body mass index(BMI),waist circumference(WC),fasting plasma glucose(FPG),and glycated hemoglobin(HbA1c).The pathophysiology of type 2 diabetes mellitus(T2DM)mainly involves insulin resistance and progressiveβ-cell failure,which leads to increased blood glucose levels(hyperglycemia)[1-3].Treatment for T2DM includes antidiabetic medications and insulin therapy[4,5].Patients with T2DM withβ-cell failure usually require insulin therapy[6-8].Continuous subcutaneous insulin infusion(CSII)and multiple daily injections(MDIs)are two major insulin therapies for controlling hyperglycemia in these patients.However,excessive insulin therapies may cause problems such as hypoglycemia,weight gain,and iatrogenic hyperinsulinemia[9].Therefore,attention should be paid to the dosage of insulin used.The establishment of insulin regimens for CSII and MDI therapies is primarily guided by physicians’empirical judgment.To date,there have been few clear guidelines or recommendations on the appropriate insulin dose during CSII and MDI treatment for T2DM[10].Yang et al[11]studied insulin doses and related factors in the CSII treatment of patients with T2DM[12].However,these studies did not cover the dose setting and related factors in MDI treatment.Previous studies have shown that patients with type 1 diabetes mellitus treated with CSII require less insulin than those treated with MDIs[13-15].However,it is unclear whether patients with T2DM on CSII also require less insulin than patients on MDI.Therefore,the present study determined the difference in insulin dosages between CSII and MDI therapies and evaluated the related factors in patients with T2DM.It also systematically analyzed the insulin dose characteristics of MDI and CSII in 954 hospitalized patients with T2DM,aiming to optimize the insulin dosage regimen and provide clinical references for guiding the application of CSII and MDI in patients with T2DM.
基金approved by the Medical Ethics Committee of the Tel Aviv Sourasky Medical Center Institutional Review Board,approval No.TLV-0674-21.
文摘BACKGROUND Intra-articular hip injections(IAHIs)are commonly used for diagnostic and therapeutic purposes but are often associated with patient anxiety and fear.The disparity between anticipated and experienced pain during IAHIs and the role of preinjection local anesthesia in pain modulation remains unclear.AIM To investigate the difference between anticipated and experienced pain during IAHIs and the impact of pre-injection local anesthesia.METHODS This prospective study enrolled 60 patients undergoing IAHI,30 receiving pre-injection superficial local anesthesia and 30 serving as a control group without pre-injection local anesthesia.Pain levels were assessed using numeric rating scales.RESULTS Patients significantly overestimated anticipated pain compared to experienced pain(6.43±2.48 vs 3.68±2.37,P<0.001).Pre-injection local anesthesia did not significantly reduce experienced pain(3.19±2.38 vs 4.20±2.29,P=0.130).CONCLUSION Patients overestimate anticipated pain during IAHIs.Pre-injection local anesthesia does not reduce experienced pain.
文摘BACKGROUND Sub-acromial injections are a therapeutic option for rotator cuff injuries;however,evidence regarding the most effective drug in this context is unclear,which needs to be investigated.AIM To evaluate the effectiveness of various sub-acromial injections for rotator cuff injuries.METHODS We conducted a systematic review and pair-wise and network meta-analyses of randomized clinical trials(RCTs)comparing sub-acromial injections for rotator cuff injuries.The interventions evaluated were hyaluronic acid(HA),platelet-rich plasma(PRP),prolotherapy,and corticosteroids.The outcomes of interest were pain and functional improvement,which were evaluated with standardized scores.The Risk of Bias 2 tool and the Grading of Recommendations,Assessment,Development and Evaluation methodology were used to assess data quality.RESULTS Twenty RCTs,comprising 1479 participants,were included.In the short term,HA achieved the best outcomes[pain mean difference(MD)=-1.48,95%confidence interval(CI)-2.37 to-0.59;function MD=10.18,95%CI:4.96-15.41].In the medium term,HA,PRP,HA+PRP,and corticosteroids were not superior to placebo in improving pain.Based on function,HA+PRP was superior to placebo,corticosteroids,and PRP(MD=26.72;95%CI:8.02-45.41).In the long term,HA,PRP,and corticosteroids were not superior to placebo in reducing pain.However,based on function,HA+PRP,PRP,and HA were superior to placebo,and HA+PRP had the best result(MD=36.64;95%CI:31.66-33.62).CONCLUSION HA provides satisfactory short-term results,while HA with PRP demonstrates functional improvement in the medium and long terms.However,no intervention maintained the pain-relief effect on>3-month follow-up.
文摘Background: Total joint replacement (TJR) patients can suffer from tendinitis, bursitis or other inflammatory conditions that are generally treated by cortisone (corticosteroid) injections. Such injections rarely cause complications in the general public, but have resulted in severe implant infections in some patients with joint replacements. The purpose of this study is to review the literature involving joint replacement infections after cortisone injections and present ozone as an alternative to cortisone in a series of joint replacement patients with periarticular inflammatory conditions. Methods: There were 26 combined patients with either total hip replacement (THR), total knee replacement (TKR), total ankle replacement (TAR), or resurfacing shoulder replacement (SR) that developed tendonitis, bursitis or inflammatory problems related to their respective joint arthroplasties. Rather than use cortisone, they were given prolozone injections into the inflammatory regions to relieve them of their pain and dysfunction. This injection was followed by an ice pack for one hour and a return to normal function thereafter. Results: All THR, TKR, SR and TAR pathologies were improved or asymptomatic after one or a series of prolozone injections into the area of inflammation. No cortisone injections were used and no infections were encountered. Conclusions: Prolozone injection therapy is an effective treatment for post-operative inflammatory conditions following total joint replacement. Patients find relief of inflammation symptoms, similar to steroid injections, without the risk of infection or tissue breakdown. Prolozone injection therapy can be useful when conventional injection treatment fails, or is contraindicated.
文摘Botulinum toxin(BT)injections to the glabellar region are emerging as a promising investigational treatment for multiple mental health conditions.By paralyzing the muscles involved in frowning,this intervention is postulated by the facial feedback hypothesis to reduce the intensity of negative affective states and has a growing body of evidence for treating major depression.However,applications to other psychiatric conditions have been relatively unexplored.This is the first study to our knowledge to examine the effect of glabellar BT on generalized anxiety.By tracking GAD-7 scores of a cosmetic population before and after receipt of glabellar BT,we observed a statistically significant decrease of anxious symptoms among patients who entered the study with a baseline level of clinical anxiety.Though more research is needed,our results suggest glabellar BT has the potential to improve symptoms of mild to moderate generalized anxiety.
基金Project supported by the National Key R&D Program of China(Grant No.2019YFE03030004)the National Natural Science Foundation of China(Grant No.12275040)+1 种基金the Users with Excellence Program of Hefei Science Center CAS(Grant No.2020HSC-UE010)This research is also sponsored in part by the U.S.Department of Energy under contract DEAC02-09CH11466.
文摘Based on the EAST equilibrium,the effects of boron(B)and neon(Ne)injected at different locations on the target heat load,and the distributions of B and Ne particles were investigated by transport code SOLPS-ITER.It was found that the B injection was more sensitive to the injection location for heat flux control than impurity Ne.The high electron and ion densities near the inner target in the discharge with impurity B injected from over X-point(R_(1))led to plasma detachment only at the inner target,and the localized B ions in the cases with injection from outer target location(R_(2))and upstream location(R_(3))led to far-SOL detachment at the outer target,but not at the inner target.In contrast,for Ne,the spatial distributions of Ne ions and electrons were found to be similar in all the cases at the three injection locations,and the detached plasma was achieved at the inner target and the electron temperature was reduced at the outer target.For locations R_(2) and R_(3),impurity B showed a more pronounced effect on the heat flux at the far-SOL of the outer target.Further analysis indicated that Ne atoms came mainly from the recycling sources,whereas B atoms came mainly from injection,and that their distinct atomic distributions resulted from the difference in the ionization threshold and ionization mean free path.In addition,the radiation proportion of B in the divertor region was larger than that of Ne when the total radiation power was similar,which suggests that B has less influence on the core region.
文摘Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men worldwide.In the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining attention.The current literature shows dataon the efficacy of intraplaque injections of hyaluronic acid(HA)mainly in acute-phase PD.However,data on injections of HA instable-phase PD are lacking.Data for this retrospective study were derived from a prospectively maintained database of privatepatients presenting at a private medical practice affiliated to the University of Naples“Federico II”(Naples,Italy)with stable-phasePD between January 2020 and March 2023.Patients underwent a standard protocol of three injections,each administered at atwo-week interval.During the intervals,patients performed vacuum device therapy,penile stretching,and modeling exercises.Allpatients compiled the Peyronie’s Disease Questionnaire(PDQ)and Global Assessment of Peyronie’s Disease(GAPD)at baselineand 2 weeks after the third injection.A penile Doppler ultrasound was performed 2 weeks after the last injection to record thefinal curvature.Overall,we recruited 62 patients with stable-phase PD and a mean(±standard deviation[s.d.])curvature of52.7°(±9.7°).After 6 weeks,eight(12.9%)patients did not experience any curvature improvement.The remaining 54 patientshad a final mean(±s.d.)curvature of 40.3°(±9.1°)with P<0.001,compared to that before treatment.We found improvement inall PDQ domains(all P≤0.01),and 50(80.6%)patients reported subjective improvement of the penile curvature according to theGAPD.In conclusion,we demonstrated that after three injections of HA administered according to the adopted protocol,patientswith stable-phase PD could experience significant improvements in penile curvature,and physical and psychological consequencesof the disease without significantly relevant side effects.
文摘●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time IVAI.The correlation of immediate IOP increase and VR rates with the four background diseases was investigated.Moreover,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were evaluated.Further,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background diseases.The immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background diseases.The immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR rate.Further,age and axial length have no correlation on immediate IOP increase and VR rate.
文摘BACKGROUND Intra-articular glenohumeral joint injections are essential procedures for treating various shoulder disorders. Fluoroscopy-guided injections have been extensively used;however, they pose a risk of radiation exposure and are expensive and timeconsuming. Recently, it has been suggested that ultrasound-guided injections are accurate and cost effective procedures.AIM To evaluate the accuracy of ultrasound-guided glenohumeral injections using a posterior approach that is confirmed using magnetic resonance arthrography(MRA).METHODS The study included 179 shoulders of patients with recurrent anterior instability(150 patients;103 and 76 right and left shoulders, respectively;160 males and 19 females;average age = 20.5 years;age range: 14-63 years) who underwent MRA for preoperative diagnosis. They were injected with 12 m L lidocaine(1%) using the ultrasound-guided posterior approach and then underwent magnetic resonance imaging. Two shoulder surgeons, except for the injector, evaluated the transverse relaxation(T2)-weighted images of axial planes and classified the intraarticular condition of injected contrast into three groups based on one of the three following scenarios: no leakage, injection into the glenohumeral joint without leakage;minor leakage, practical intra-articular injection with some leakage outside the posterior rotator cuffs;and major leakage, inaccurate injection with mass leakage without any contrast into the joint. The inter-rater reliability between two assessors was also evaluated by calculating Cohen’s kappa coefficient. The learning curve was assessed regarding the inaccurate injection rate by analyzing Spearman’s rank correlation coefficient.RESULTS Of the 179 injections, 163 shoulders(91.0%) had no leakage, 10 shoulders(5.6%) had minor leakage, and six shoulders(3.4%) had major leakage. In total, 173 shoulders(96.6%) were intraarticularly injected;thus, we could detect anterior labrum and capsular pathologies. Regarding the inter-rater reliability, the kappa coefficient was 0.925, indicating consistency in the evaluations by both examiners. Regression analysis of the inaccurate injection rate for assessingtechnical learning showed a logarithmic curve with a downward trend(R;= 0.887, P < 0.001). Three(50%) of the six inaccurate injections classified into “major leakage” were observed in the first 30 injections, indicating that the accurate injection showed a leaning effect.CONCLUSION Ultrasound-guided intra-articular glenohumeral injections using a posterior approach had high accuracy;however, injection accuracy depends on clinical experience.
基金surported by the National Natural Science Foundation of China(No.81803608)the Administration of Traditional Chinese Medicine of Jilin Province,China(No.2019133)
文摘The aim of this study was to explore the neuroprotective effect and mechanism of XingNaoJing injections(XNJ) on cerebral ischemia injury and blood-brain barrier(BBB) disruption. Middle cerebral artery occlusion(MCAO) method was applicated to establish the model of cerebral ischemia/reperfusion(I/R) injury in rats. BBB permeability after I/R injury was assessed with the leaking amount of Evans Blue and the expression of occludin and ZO-1. The expression of NOD-like receptor family, pyrin domain containing(NLRP3) was checked to explore the inhibition of inflammation by XNJ. The results showed that XNJ could significantly increase the survival percent, decrease the infarct area and ameliorate neurological deficits and brain damage after I/R injury. Leaking amount of Evans Blue was reduced by XNJ, and the expression of tight junction protein, occludin and ZO-1 was also up-regulated by XNJ, which showed a role of protection on BBB disruption. The expression of NLRP3 was inhibited after exposure of XNJ, which was associated with inhibition of the inflammatory response. In summary, XNJ could suppress NLRP3 inflammasomes and improve BBB disruption and brain damage in rats after cerebral I/R injury, which provided a beneficial insight to further explore XNJ.
文摘Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.
基金Supported by National Natural Science Foundation of China(Study on the Key Influencing Factors of Anaphylaxis in Traditional Chinese Medicine Injection No.81473547and Multidimensional Clinical Evaluation Model of Salvia Injection for the Treatment of Unstable Angina Pectoris,No.81673829)
文摘OBJECTIVE:To assess the clinical efficacy and safety of ginkgo injections(GIs)combined with conventional treatment(CT)against angina pectoris(AP)due to coronary heart disease(CH D).METHODS:Randomized controlled trials(RCTs)that used GIs to treat AP were searched in SinoMed,PubMed,China National Knowledge Infrastructure Database,Chinese Scientific Journals Database,Wanfang Database,Embase and Cochrane Library until March 2017.The Cochrane "risk of bias" method was used to evaluate the methodological quality of RCTs.Data were analyzed using Stata v13.1 and WinBUGS v1.4.3.RESULTS:A total of 73 RCTs involving 7621 patients were included.A Bayesian network Meta-analysis of RCTs was undertaken,and the advantages of four types of Gl-supplemented CT in AP treatment were determined.CONCLUSION:Gl-assisted CT was more effective against AP than CT alone.However,based on the limitations of the study,additional high-quality RCTs are required to confirm our findings.
基金Supported by the National Natural Science Foundation of China(Study on the Key Influential Factors of Anaphylaxis Induced by Chinese Herbal Injection Based on Three-dimensional Database and Multi-dimensional Data Mining,No.81473547Establishment of Multi-dimensional Clinical Evaluation Model of Danshen Injection for Treating Unstable Angina Pectoris Based on Bayesian Network Meta Analysis,No.81673829)。
文摘OBJECTIVE: To address the optimal Chinese herbal injections(CHIs) against liver cancer, the present network Meta-analysis is designed to investigate the comparative efficacy and safety of different CHIs.METHODS: Several electronic databases were searched up to June 1 st, 2017. The quality assessment was conducted and network Meta-analysis was performed to compare the efficacy and safety of different CHIs plus transcatheter hepatic arterial chemoembolization(TACE). Primary outcomes were 1-year and 2-year survival rate, the secondary outcomes includes the clinical effective rate, performance status and the adverse reactions(ADRs). Data analysis was applied Stata 13.0 and Win BUGS 1.4 software.RESULTS: A total of 105 randomized controlled trials(RCTs) were identified for inclusion in this analysis, with data for 7683 patients and 13 CHIs. The results suggested that Javanica oil emulsion,Huachansu injection plus TACE were more favorable for 1-year and 2-year survival rate than other CHIs. Kanglaite, Astragalus polysaccharide injection plus TACE showed superiority in the clinical effective rate and performance status over other CHIs.And Shenmai injection plus TACE was superior to reducing ADRs than other CHIs for patients with liver cancer.CONCLUSION: Our findings indicated that receiving CHIs combined with TACE may have therapeutic benefits for patients with liver cancer in improving survival rate, clinical effective rate, the performance status and alleviating the ADRs.
文摘OBJECTIVE： To ascertain if it is effective to use extradural injections and manual repositioning of the spine to treat megalgia caused by cervical spondy- Iotic radiculopathy （CSR）. METHODS： Patients with megalgia caused by CSR were divided into a treatment group （n=46） treated by extradural injection and manual repositioning of the spine and a control group （n=46） treated by a conventional method. RESULTS： The prevalence of cure was 58.69% and the total prevalence of effective cure in the treatment group was 97.83% and was 23.91% and 78.26%, respectively, in the control group： this difference between the two groups was significant （P〈 0.05）. CONCLUSION： Treatment of megalgia caused by CSR by extradural injections and manual repositioning of the spine has a good curative effect with rapid analgesia and short therapeutic course.
基金supported by 973 Project from the Ministry of Science and Technology of China(No.2010 CB735604)
文摘The present study was designed to determine the relationships between the performance of ethanol precipitation and seven process parameters in the ethanol precipitation process of Re Du Ning Injections,including concentrate density,concentrate temperature,ethanol content,flow rate and stir rate in the addition of ethanol,precipitation time,and precipitation temperature.Under the experimental and simulated production conditions,a series of precipitated resultants were prepared by changing these variables one by one,and then examined by HPLC fingerprint analyses.Different from the traditional evaluation model based on single or a few constituents,the fingerprint data of every parameter fluctuation test was processed with Principal Component Analysis(PCA)to comprehensively assess the performance of ethanol precipitation.Our results showed that concentrate density,ethanol content,and precipitation time were the most important parameters that influence the recovery of active compounds in precipitation resultants.The present study would provide some reference for pharmaceutical scientists engaged in research on pharmaceutical process optimization and help pharmaceutical enterprises adapt a scientific and reasonable cost-effective approach to ensure the batch-to-batch quality consistency of the final products.
文摘Spinal pain(SP)is a common condition that has a major negative impact on a patient’s quality of life.Recent developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical practice.This clinical expert consensus describes the purpose,significance,implementation methods,indications,contraindications,and techniques of ultrasound-guided injections.This consensus offers a practical reference point for physicians to implement successfully ultrasound-guided injections in the treatment of chronic SP.
基金supported by the National Natural Science Foundation of China under grant 41974188。
文摘Relativistic electron injections are one of the mechanisms of relativistic(≥0.5 MeV) electron enhancements in the Earth’s outer radiation belt. In this study, we present a statistical observation of 600 keV electron injections in the outer radiation belt by using data from the Van Allen Probes. On the basis of the characteristics of different injections, 600 keV electron injections in the outer radiation belt were divided into pulsed electron injections and nonpulsed electron injections. The 600 keV electron injections were observed at 4.5 < L <6.4 under the geomagnetic conditions of 450 nT < AE < 1,450 nT. An L of ~4.5 is an inward limit for 600 keV electron injections. Before the electron injections, a flux negative L shell gradient for ≤0.6 MeV electrons or low electron fluxes in the injected region were observed. For600 keV electron injections at different L shells, the source populations from the Earth’s plasma sheet were different. For 600 keV electron injections at higher L shells, the source populations were higher energy electrons(~200 keV at X ~–9 R_(E)), whereas the source populations for 600 keV electron injections at lower L shells were lower energy electrons(~80 keV at X ~–9 R_(E)). These results are important to further our understanding of electron injections and rapid enhancements of 600 keV electrons in the Earth’s outer radiation belt.
文摘AIM: To assess the effect of lens status on sustained intraocular pressure(IOP) elevation in patients treated intravitreally with anti-vascular endothelial growth factor(VEGF) agents. METHODS: Data were retrospectively collected for all patients treated with intravitreal injections of anti-VEGF medication at a tertiary medical center in July 2015. Findings were analyzed by lens status during 6 months' follow-up. The main outcome measure was a sustained increase in IOP(≥21 mm Hg or change of ≥6 mm Hg from baseline on ≥2 consecutive visits, or addition of a new IOPlowering medication during follow-up). RESULTS: A total of 119 eyes of 100 patients met the study criteria: 40 phakic, 40 pseudophakic, and 39 pseudophakic after Nd:YAG capsulotomy. The rate of sustained IOP elevation was significantly higher in the postcapsulotomy group(23.1%) than in the phakic/pseudophakic groups(8.1%;P=0.032), with no statistically significant differences among the 3 groups in mean number of injections, either total(P=0.82) or by type of anti-VEGF mediation(bevacizumab: P=0.19;ranibizumab: P=0.13), or mean follow-up time(P=0.70). CONCLUSION: Nd:YAG capsulotomy appears to be a risk factor for sustained IOP elevation in patients receiving intravitreal anti-VEGF injections. This finding has important implications given the growing use of anti-VEGF treatment and the irreversible effects of elevated IOP.
文摘Aim： To assess the behavior of patients with diabetes mellitus （DM） and erectile dysfunction （ED） during 10 consecutive years of treatment with self-injection of vasoactive drugs. Methods： Thirty-eight diabetic men, including 12 with type Ⅰ and 26 with type Ⅱ diabetes, were followed up regularly for 10 years after they began self-injecting for severe ED. Real time rigidity assessment was used for the objective determination of the initial dosage and then doses were regulated in order to introduce an erection suitable for penetration and maintenance of erection for approximately 30 min. Patients were followed up every two months, and doses were increased only when the treatment response was not satisfactory. Results： The number of injections used per year by the patients was reduced each year （mean numbers： 50 in the first year and 22.5 in the 10th） and treatment shifted towards stronger therapeutic modalities （mixtures of vasoactive drugs instead of prostaglandin E1 alone）. Type Ⅰ diabetic men were standardized to a level of treatment as early as 5 years after the initiation of treatment. That level was finally reached by type Ⅱ patients after another 4-5 years. Conclusion： Treatment with self-injections of vasoactive drugs in diabetic men with severe El） is a safe and effective alternative in the long term. Diabetic men of both types show the same preferences in quality and quantity of treatment after 10 years. The key point for maintenance in treatment is the adjustment of the therapeutic method and dosage to optimal levels for satisfactory erections. （Asian J Androl 2006 Mar; 8： 219-224）
