Objective To assess the effectiveness and safety of Fushenqudu capsules in the treatment of chronic renal failure. Methods The double blind, double dummy and randomized controlled method was adopted. One hundred and thirty one patients were randomized to the trial group (n=88, Fushenqudu capsule, 4 capsules, qid) and the control group (n =43, Shenshuaining capsules, 4 capsules, qid). The therapeutic duration for both groups was 8 weeks. Results The results were analyzed on the basis of intention-to-treat. For effectiveness of treatment, the markedly effective rate was 27.3% (24/88); the total effective rate was 67.0% (59/88) in the treatment group; the markedly effective rate was 25.6% (11/43), the total effective rate was 58.1% (25/43) in the control group. There was no statistical difference between the two groups (Pgt;0.05). For effectiveness of Pishenqixu syndrome, the markedly effective rate was 48.9% (43/88) and 53.3% (23/43) respectively in the trial and control groups. No statistically significant difference was tested between the two groups (Pgt;0.05). Mild adverse effects occurred in two groups. When a smaller dose or termination of the drug were applied, the symptoms went. The tolerance was good when the patients took the medicine regularly. Conclusions Fushenqudu capsules have the same clinical effect as Shenshuaining capsule with a little toxic adverse effects.
Objective To introduce the research update of microencapsulation and its application in orthopedics. Methods Recent articlesconcerned were extensively reviewed. Results Drugs and cells modified by genecould be encapsulated in different materials and be implanted in vivo avoiding a host immune system rejection. It act as a continuous source of desired medicine for enhancement of bone healing, the treatment of bone tumor and bone infection, and the regeneration of bone and cartilage. Conclusion Microencapsulation can be used asa carrier for drugs and cells modified gene to treat related disease in orthopedics.
Objective To evaluate the effects of intraocular lenses (IOL) of silicone and polymethylmethacrylate (PMMA) on posterior capsule opacification (PCO). Methods We searched MEDLINE (1966 to 2003), EMBASE (1980 to 2003), Cochrane Central Register of Controlled Trials (Issue 1, 2003) and CBMdisc (1979 to 2003). Only randomized controlled trials (RCTs) were identified. Two reviewers independently assessed the quality of the included trial and extracted data. The following outcomes were assessed: PCO index, percentage of neodymium: YAG (Nd: YAG) laser posterior capsulotomy and visual acuity after cataract surgery. RevMan 4.2 was used for meta-analysis.Results Nine RCTs including 672 eyes were included. In patients with senile cataract, the results of meta-analysis suggested that silicone lens were better than PMMA lens on PCO index (the pooled SMD=－0.92, 95%CI －1.19 to －0.64) and percentage of Nd: YAG (the pooled OR 0.35, 95%CI 0.22 to 0.57) with a statistically significant difference, but there was no significant difference on visual acuity (the pooled OR 1.22, 95%CI 0.43 to 3.50) after cataract surgery between silicone lens and PMMA lens. However, in patients with uveitic cataract, the results of meta-analysis showed that PMMA lens were better than silicone lens in visual acuity (the pooled OR 0.38, 95%CI 0.15 to 0.91) after cataract surgery with a statistically significant difference, but there was no significant difference on PCO index (SMD 0.23, 95%CI －0.59 to 1.05) and percentage of Nd: YAG (the pooled OR 1.82, 95%CI 0.47 to 6.95) between silicone lens and PMMA lens. Conclusions Current evidence indicates that silicone lens are superior to PMMA lens in reducing PCO. Further trials with high quality on methodology are required.
ObjectiveTo observe the safety and efficacy of Keluoxin capsules in the treatment of moderate to severe non-proliferative diabetic retinopathy (NPDR). MethodsAn open-label, multi-center, single-arm, phase Ⅱa clinical trial. From May 2014 to December 2016, the patients diagnosed with moderate to severe NPDR who received Keroxin treatment in General Hospital of Central Theater Command, Affiliated Eye Hospital to Nanchang University, Xiyuan Hospital of China Academy of Chinese Medical Sciences, and Eye Hospital China Academy of Chinese Medical Sciences were divided into moderate NPDR group and severe NPDR group. The baseline data of the patients were obtained, best-corrected visual acuity (BCVA), optical coherence tomography, fundus fluorescein angiography and fundus photography were performed. On the basis of maintaining the original diabetes treatment, all patients took Keluoxin capsules orally for 24 weeks; 24 weeks after treatment was used as the time point for evaluating the efficacy. BCVA letters, central macular thickness (CMT) and 6 mm diameter total macular volume (TMV), retinal vascular leakage area, and retinal non-perfusion (RNP) area within an average diameter of 6 mm were compared between the two groups at baseline and 24 weeks after treatment. Independent sample Mann-Whitney U test was used to compare continuous variables between groups. Categorical data were compared by χ2 test. ResultsA total of 60 NPDR patients and 60 eyes were included, 9 cases were lost to follow-up, and 51 cases and 51 eyes were finally included, including 37 eyes in the moderate NPDR group and 14 eyes in the severe NPDR group, respectively. At baseline, BCVA in moderate NPDR group and severe NPDR group were (80.1±6.8), (81.4±6.3) letters, respectively. CMT were (249.5±32.1), (258.9±22.2) μm, respectively. TMV were (8.79±1.09), (8.95±1.31) mm3, respectively. Retinal vascular leakage areas were (7.69±10.63), (10.45±7.65) mm2, respectively. RNP area were (2.48±5.74), (10.63±20.06) mm2, respectively. There were 11 (29.7%, 11/37) and 4 (28.6%, 4/14) eyes with diabetic macular edema (DME), respectively; 24 weeks after treatment, BCVA in moderate NPDR group and severe NPDR group increased by (1.3±5.2), (3.2±3.0) letters, respectively. Compared with baseline, there was a statistically significant difference in the severe NPDR group (t=－3.986, P=0.033). CMT were (252.1±45.6), (269.8±57.2) μm, respectively. There were no significant differences compared with baseline (t=－0.567, －0.925; P＞0.05). TMV were (9.96±1.16), (10.09±1.32) mm3, respectively. There were no significant differences compared with baseline (t=－0.996, －1.304; P＞0.05). Retinal vascular leakage area decreased (0.19±6.90), (1.98±7.52) mm2, respectively. There were no significant differences compared with baseline (t=0.168, 0.983; P＞0.05). RNP area were (3.01±6.47), (10.36±19.57) mm2, respectively. Compared with baseline, the differences were statistically significant (t=－1.267, 0.553; P＞0.05). There were 8 (21.6%, 8/37) and 3 (21.4%, 3/14) eyes with DME, respectively. Compared with baseline, the difference was statistically significant (χ2=11.919, 4.571; P=0.001, 0.033). ConclusionKeluoxin capsules can stabilize or improve BCVA, CMT, TMV and RNP area in patients with moderate and severe NPDR, and reduce the area of retinal vascular leakage.
This study aims to explore the effects of alginate-poly ornithine-alginate (A-PLO-A) and barium alginate-poly ornithine-alginate (B-PLO-A) microcapsules as cells carriers during implantation. Mice hepatocytes coated in A-PLO-A and B-PLO-A microcapsules were implanted into rats with acute liver failure caused by intraperitoneal injection of D-galactosamine. The rat survival rate, liver cell growth, proliferation and metabolism within the microcapsules were investigated, as well as its effect on the improvement of rat acute liver failure. The influence of A-PLO-A-free microcapsules, B-PLO-A-free microcapsules, isolated liver cells, A-PLO-A microcapsule-coated and B-PLO-A microcapsule-coated liver cells was studied. It was found that the chemical-free microcapsules showed no positive effect on the rats with liver failures, with a death rate of 100% in both groups 3 days after the implantation. The ALT, AST and ALB levels were all improved in the isolated liver cell group, the A-PLO-A microcapsule-coated and the B-PLO-A microcapsule-coated groups. The survival rate of both microcapsule-coated liver cell groups was significantly higher than that of the chemical-free microcapsule group and the isolated liver cells group. The microcapsules were retrieved after 4 weeks' implantation, which were observed to be smooth with no cells attaching to the surface. No apparent fibrosis was observed. This research demonstrated the physical stability and the biocompatibility of the PLO-based alginate microcapsules and therefore they could be used as liver cell carriers during implantation.
ObjectiveTo introduce the surgery method to reset and fix tibial plateau fracture without opening joint capsule, and evaluate the safety and effectiveness of this method.
MethodsBetween July 2011 and July 2013, 51 patients with tibial plateau fracture accorded with the inclusion criteria were included. All of 51 patients, 17 cases underwent open reduction and internal fixation without opening joint capsule in trial group, and 34 cases underwent traditional surgery method in control group. There was no significant difference in gender, age, cause of injury, time from injury to admission, side of injury, and types of fracture between 2 groups (P>0.05). The operation time, intraoperative blood loss, incision length, incision heal ing, and fracture healing were compared between 2 groups. The tibial-femoral angle and collapse of joint surface were measured on X-ray film. At last follow-up, joint function was evaluated with Hospital for Special Surgery (HSS) knee function scale.
ResultsThe intraoperative blood loss in trial group was significantly less than that in control group (P<0.05). The incision length in trial group was significantly shorter than that in control group (P<0.05). Difference was not significant in operation time and the rate of incision heal ing between 2 groups (P>0.05). The patients were followed up 12-30 months (mean, 20.4 months) in trial group and 12-31 months (mean, 18.2 months) in control group. X-ray films indicated that all cases in 2 groups obtained fracture heal ing; there was no significant difference in the fracture healing time between 2 groups (t=1.382, P=0.173). On X-ray films, difference was not significant in tibial-femoral angle and collapse of joint surface between 2 groups (P>0.05). HSS score of the knee in trial group was significantly higher than that of control group (t=3.161, P=0.003).
ConclusionIt can reduce the intraoperative blood loss and shorten the incision length to use open reduction and internal fixation without opening joint capsule for tibial plateau fracture. Traction of joint capsule is helpful in the reduction and good recovery of joint surface collapse. In addition, the surgery without opening joint capsule can avoid joint stiffness and obtain better joint function.
ObjectivesTo systematically evaluate the efficacy and safety of butylphthalide soft capsule in the treatment of vascular dementia (VaD).MethodsDatabases including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, The Cochrane Library were electronically searched to collect randomized controlled trials of butylphthalide soft capsule in the treatment of vascular dementia published from September 2002 to July 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 15 studies involving 1 149 patients were included. The butylphthalide soft capsule treatment group included 578 patients and the control group included 571 patients. The results of meta-analysis showed that compared with the control group (donepezil hydrochloride tablets or memantine hydrochloride tablets or EGb761 or negative control), the butylphthalide soft capsule treatment group improved the MMSE score of patients with VaD (MD=3.52, 95%CI 2.59 to 4.46, P<0.01), CDR score (MD=?0.72, 95%CI ?0.80 to ?0.65, P<0.01), and treatment efficiency (RR=1.31, 95%CI 1.20 to 1.43, P<0.01). However, there was no statistical difference in the number of adverse reactions between the treatment and control groups.ConclusionsButylphthalide soft capsule can be used in the treatment of patients with mild to moderate VaD. It can improve the cognitive function, raking of clinical dementia, and increase the effect rate of treatment. It can also work in conjunction with other drugs that improve cognitive function and no increase in adverse reactions has been found. However, due to the low quality of the included studies and small sample size, the actual efficacy strength is uncertain and the above conclusions are still required to be verified by more high-quality randomized controlled trials.
ObjectiveTo evaluate the combination efficacy with Qingfei Yihuo capsule and routine antibiotics as well as mucopolytic agents in the treatment of bronchiectasis acute exacerbation.MethodsThis was a prospective, multi-center, randomized controlled clinical study. The efficacy of Qingfei Yihuo capsule combine with routine antibiotics and mucopolytic agents in the treatment of bronchiectasis acute exacerbation was compared according to the symptom control as well as exacerbation duration. Through randomization, patients received Qingfei Yihuo capsule or placebo combine with routine antibiotics and mucopolytic agents treatment for 10 days. Symptom score of cough, sputum, short of breath pre- and post-treatment as well as the symptom score in daily card were compared between the two groups. The spirometry and St. George respiratory questionnaire (SGRQ) before and after treatment were compared.ResultsThis study was conducted from June 2017 to August 2018. One hundred and ninety patients from 7 centers in 6 hospitals with bronchiectasis acute exacerbation were enrolled in the study. There was statistically improvement of symptom score (including the 9th and 10th treatment days) according to the daily card recording in Qingfei Yihuo capsule group compared to the placebo group, but no statistically significant difference was found in spirometry results or SGRQ.ConclusionQingfei Yihuo capsule has assistant effect on improving respiratory symptoms of bronchiectasis exacerbation.
ObjectiveTo investigate the clinical efficacy and mechansim of massive hepatocarcinoma with different imaging appearance after transcatheter arterial chemoembolization(TACE).
MethodsThe image data of 38 patients with massive hepatocarcinoma were collected and analized retrospectively. According to the tumor edge situation on CT images before TACE treatment, the patients were divided into two groups:the sharp-edged tumor group and indistinct-edged tumor group. The efficacy were evaluated according to the imaging appearance after treatment.
ResultsThe differences of the positive cases of HbsAg and AFP, Child-Pugh class, maximum tumor diameter, and dosage of lipiodol between the two groups before procedure were not statistic significance(P > 0.05). Six months after TACE, the maximum tumor diameter of the sharp-edged tumor group and indistinct-edged tumor group was(8.2±1.48) cm and(12.2±1.67) cm, respectively, the difference between the two groups was statistic significance(P < 0.05). In accordance with lipiodol deposition, ⅠandⅡtype were found in the sharp-edged tumor group withoutⅢandⅣtype. Most wereⅡandⅢtype with lessⅠtype and severalⅣtype in the indistinct-edged tumor group. According to the size of tumor six months after TACE, the total effective rate(CR+PR) was 92.9% and 62.5%, respectively in the sharp-edged tumor group and indistinct-edged tumor group. There were significantly difference between the two groups in iodized oil distribution and tumor size after procedure(P < 0.05). No statistical difference was found between the incidence rate of complications in two groups(P > 0.05).
ConclusionThe efficacy of massive hepatocarcinoma in patients with sharp-edged tumor on CT images is better than those with indistinct-edged tumor.
To investigate the anatomic feature of the posterior hip joint capsule and its distributional difference of collagen fibers and to probe the optimization of the capsulotomy which can reserve the best strength part. Methods Ten adult cadaver pelvises (6 males and 4 females, aged 28-64 years) fixed with formal in were used. Ten right hips were used for anatomical experiment of hip joint capsule. The posterior hip joint capsules were divided into 3 sectors(I-III sectors ) and 9 parts (IA-C, IID-F, IIIG-I). The average thickness of each part was measured and the ischiofemorale l igaments were observed. Five capsules selected from ten left hips were used for histological experiment. The content of collagen fibers in sector I and sector II was analyzed by Masson’s staining. Two fresh frozen specimens which were voluntary contributions were contrasted with the fixed specimens. The optimal incision l ine of the posterior capsule was designed and used. Results The thickness in the posterior hip joint capsule [IA (2.30 ± 0.40), IB (4.68 ± 0.81), IC (2.83 ± 0.69), IID (2.80 ± 0.79), IIE (4.22 ± 1.33), IIF (2.50 ± 0.54), IIIG (1.57 ± 0.40), IIIH (2.60 ± 0.63), IIII (1.31 ± 0.28) mm] had no uniformity (P lt; 0.01). The IIIG part and the IIII part were thinner than the IB part and the IIE part (P lt; 0.01). Two weaker parts located at obturator externus sector (sector III), the ischiofemorale l igament trunk went through two thicker parts (IB and IIE). The distribution of the collagen fibers in sector I and sector II(IA 20.34% ± 5.14%, IB 48.79% ± 12.67%, IC 19.87% ± 5.21%, IID 17.57% ± 3.56%, IIE 46.76% ± 11.47%, IIF 28.65% ± 15.79%) had no uniformity (P lt; 0.01). The content of collagen fibers in IB part and IIE part were more than that of other parts (P lt; 0.01). There were no statistically significant difference in the distribution feature of the thickness and the ischiofemorale l igaments between the fresh frozen specimens and the fixed specimens. The optimal incision l ine C-A-B-D-E of the posterior capsule was designed and put into cl inical appl ication. The remaining capsular flap comprise the most of the ischiofemorale l igament trunk and the part of gluteus minimus. Conclusion Although enhanced posterior soft tissue repairin total hip arthroplasty was investigated deeply and obtained great development, but the postoperative dislocation rate was not el iminated. It is significant for optimizing the capsulotomy to reserve the best strength part of the posterior capsule and to bring into full play the function of the ischiofemorale l igaments.
