Objective To assess the effectiveness and safety of Shenfutuodu capsule in the treatment of opioid withdrawal syndrome. Methods We searched The Cochrane Library （Issue 1 , 2005 ） , MEDLINE （1966 -2005） , EMBASE （1974-2005） , and some Chinese databases for additional articles （CBMdisc, CMCC, VIP, CNKI ） （1980-2005 ）. The quality of included randomized controlled trials was evaluated and meta-analysis was performed.Results Our initial search identified just three studies involving 293 patients met the inclusion criteria and were of higher quality. There was a statistical difference between Shenfutuodu capsule and clonidine groups on the fifth day in withdrawl symptom score with weight mean difference （WMD） -3.14 and 95% confidence interval （CI） -6.28 to -0.01. And no statistical difference was detected between the two groups in withdrawal symptom score on the 0th-4th day and the 6th-10th daywith WMD 58.45（95% CI 53.88 to 63.02）, -1. 15 （95% CI -5.69 to 3.40） , -0.42（95% CI -4.55 to 3.70）, -0.77（95%CI -4.37 to 2. 84）, -1.54（95%CI -4.78 to 1.69）, -1.76（95%CI -4.25 to0.74） , -1.74（95%CI -3.89 to0.41）, -1.24（95%CI -3.28 to0.80）, -0.52（95%CI -1.96 to0.92 ） and -0.27（95% CI -1.64 to 1.11 ） respectively. There was no statistical difference on effectiveness between the two groups on the third day with WMD 1.52, （95% CI 0.79 to 2.95）. There was no statistical difference between the two groups in HAMA score on the first , fifth and tenth day with WMD -0.55（95% CI -3.74 to 2.64） , 0.34 （95% CI -2.02 to 2.70） , 0. 63 （95% CI -0.21 to 1.47 ） respectively. There was a statistical difference between the two groups in dizziness rate with RR 0.73 （95% CI 0.62 to 0.87 ） . No statistical difference was detected between the two groups in dry mouth with RR 1.11（95% CI 0.95 to 1.29） , somnolence with RR 0.99（95% CI 0.82 to 1.21） , and blurred vision with RR 0.92（95% CI 0.70 to 1.19）. Statistical difference was detected between the two groups in side effect score on the second day with WMD -1.26 （95% CI -2.40 to -0. 12 ）. No statistical difference was detected between the two groups in side effect score on the first day, the third to tenth day with WMD -0.55 （ 95% CI -1.48 to0.38）, -0.63 （95%CI -1.67 to0.42）, -0.84 （95%CI -1.77 to0.09）, -0.29 （95%CI -1.09 to 0.51）, 0.15 （95% CI -0.52 to 0.81）, 0. 22 （95% CI -0.22 to 0.67）, 0.09（95% CI -0.25 to 0.44）, 0.03 （95% CI -0.21 to 0.27） , -0.03 （95% CI -0.33 to 0.26） respectively. Conclusions Based on the current evidence, Shenfutuodu capsule may be an effective and safe drug or abstinence of drug addiction. More well designed randomized controlled trials are required .
ObjectiveTo explore the clinical effect of keeping the pancreatic capsule in radical gastrectomy for early stage of gastric cancer. MethodsTwo hundreds and seven patients with early stage of gastric cancer who were treated in our hospital from Jan 2011 to December 2011 were enrolled prospectively, and were divided into experimental group (n=95) and control group (n=112). Patients in experimental group kept the pancreatic capsule in radical gastrec-tomy, but patients in control group didn't keep the pancreatic capsule. Comparison of the clinical effect between the 2 groups was performed. ResultsThe blood loss[(134.1±5.3) mL vs. (150.3±3.7) mL] and operation time[(76.4±5.7) min vs. (87.5±9.1) min]of experimental group were all lower or shorter than those of control group (P<0.05), but there were no significant difference between the 2 groups in incidence of total complication[7.37% (7/95) vs. 10.71% (12/112)], stomal leak[3.16% (3/95) vs. 4.46% (5/112)], and anastomotic stenosis[4.21% (4/95) vs. 6.25% (7/112)], P>0.05. All of the 207 patients were followed-up for 1-36 months, with the median time of 17.5 months. During the follow-up period, in experimental group, there were 30 patients suffered from recurrence, 23 patients suffered from metastasis, and 44 patients died, and the 1-and 3-year survival rates was 84.21% (80/95) and 53.68% (51/95) respectively, 1- and 3-year disease free survival rates was 80.00% (76/95) and 48.42% (46/95) respectively; in control group, there were 37 patients suffered from recurrence, 23 patients suffered from metastasis, and 49 patients died, and the 1-and 3-year survival rates was 85.71% (96/112) and 56.25% (63/112) respectively, 1-and 3-year disease free survival rates was 81.25% (91/112) and 49.11% (55/112) respectively. There were no significant difference in the 1-and 3-year survival rate, 1-and 3-year disease free survival rate (P>0.05). In addition, there were no significant difference in the survival and disease free survival situation (P>0.05). ConclusionsSurvival and disease free survival situation of keeping the pancreatic capsule in radical gastrectomy is similar with traditionally radical gastrectomy, but surgery of keeping the pancreatic capsule in radical gastrectomy has the advantages of less bleeding and shorter operation time, which is worthy of further study.
Objective To explore the surgical technique and preliminary safety and aesthetic results of endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation for patients. MethodsThe clinical data of 25 patients who underwent endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation between April 2020 and January 2024 and met the selection criteria was retrospective analysed. The patients’ age ranged from 33 to 73 years, with a mean of 50.4 years, and the body mass index ranged from 16.8 to 26.6 kg/m2, with a mean of 21.5 kg/m2. They were all bilaterally injected with Amazingel, and the time between initial injections and surgery ranged from 17 to 26 years, with a mean of 21.4 years. Early safety was evaluated by the incidence of early postoperative complications, and early aesthetic results were evaluated using Harris scores (including breast shape satisfaction, sensation satisfaction, and elasticity satisfaction) at 3 months after operation. Results There were 9 cases underwent Amazingel removal (group A) and 16 cases underwent Amazingel removal with immediate prepectoral implant-based breast augmentation (group B). Intraoperative removal of Amazingel ranged from 808 to 1 285 mL, with a mean of 1 050.7 mL; the mass of the capsule removed ranged from 36 to 169 g, with a mean of 103.6 g; and a gross anatomical prosthesis was used with a median size of 345 mL (range, 315-355 mL). The operation time ranged from 95 to 395 minutes, with a mean of 194.2 minutes; and the cost of the procedure ranged from 8000to 91 000 yuan, with a mean of 33 000 yuan. Patients had a median follow-up time of 22.7 months (range, 3.0-48.1 months). There was 1 case of intraoperative skin burn due to the operation of the electric scalpel, which healed naturally after operation without flap necrosis. There was no adverse conditions such as prosthesis outline showing, ripple sign, and capsular contracture during follow-up; a small amount of Amazingel residue was found in 2 patients at 1 year after operation. The Harris score at 3 months after operation was used to evaluate the early aesthetic results, and the breast shape, elasticity, and sensation satisfaction of group A were lower than group B, but the differences between the two groups were not significant (P>0.05). Conclusion Endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation is safe in the early stage with good aesthetic results, and it is also recommended that patients who had the indications for combined immediate breast augmentation after removal to rebuild the breast appearance.
Objective To evaluate the effect of PNS on Idiopathic facial palsy. Methods A total of 86 cases of acute idiopathic facial paralysis were randomly divided into the treatment group (PNS group, 44 cases), and the control group (42 cases). The basis of the two groups included hormone therapy, B vitamins, anti-viral treatment, as well as acupuncture and physical therapy, both in the incidence of 7 days to give the treatment. House-Brackmann facial nerve function classification and evaluation were used to determine clinical efficacy; ENoG line was tested before and after treatment. Results Before H-B classification of facial nerve function, EnoG side of the latency and amplitude in the two groups were comparable. At 28 days after treatment, H-B scores for the treatment group and the control group were (2.33 ± 1.21) and (3.08 ± 1.35), respectively, and the two groups had significant differences (Plt;0.05); ENoG incubation period (2.46 ± 0.34) and amplitude (189 ± 67) of the treatment group were more than those of the control group; the incubation period (3.37 ± 0.49) and amplitude (131 ± 52) improved, and there were significant differences between the two groups (Plt;0.05). Comparison of efficacy of the two groups showed the total effective rate: 95.45% in the treatment group, 80.95% in the control group, and the efficacy of the treatment group was better than that of the control group (Plt;0.05). Conclusion Sanqi tongshu, B vitamins, anti-virus, such as the acupuncture and physical therapy for the treatment of acute idiopathic facial paralysis have significant effect.
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.
Effective postoperative pain management in patients undergoing total knee arthroplasty is an important part of the realization of enhanced recovery after surgery. Peripheral nerve block is of great significance to the control of postoperative pain, and clinicians are committed to finding a nerve block that has little impact on muscle strength and is conducive to the early recovery of motor function after total knee arthroplasty. Infiltration between the popliteal artery and capsule of the knee block can selectively block the sensory branch of the posterior end of the knee joint without affecting the motor branch of the common peroneal nerve, so that the muscle strength can be minimally affected under the condition of adequate analgesia. This article reviews the proposal of infiltration between the popliteal artery and capsule of the knee block, the approach and method of the block, and the advantages of combining with different nerve blocks for analgesia after total knee arthroplasty.
Objective To assess the efficacy and safety of Guizhifuling capsule versus western medicine in the treatment of uterine myoma. Methods Randomized controlled trials (RCTs) involving Guizhifuling capsule versus western medicine in the treatment of uterine myoma were identified from CBM (1978 to 2009), VIP (1989 to 2009), WANFANG Database (1998 to 2009), CNKI (1979 to 2009). We also manually searched relevant journals from Tianjin University of Traditional Chinese Medicine. Data were extracted and evaluated by two reviewers independently with a specially designed extraction form. The Cochrane Collaboration’s RevMan 5.0.22 software was used for data analyses. Results A total of 8 trials involving 798 patients were included. The results of meta-analyses showed that, a) the mean uterine myoma volume in the experimental group was different when compared with the mifepristone group (WMD= 0.64, 95%CI 0.56 to 0.71); b) no difference was found between the experimental group and the mifepristone group in serums hormone level, such as, follicle-stimulating hormone (WMD= 2.40, 95%CI –?3.09 to 7.89), luteinizing hormone (WMD= 1.22, 95%CI –?1.05 to 3.49), estriol (WMD= 11.07, 95%CI –?7.70 to 29.84), and P (WMD= 0.52, 95%CI –?0.33 to 1.37); c) As for clinical symptoms effective rate, significant difference was noted between the experimental group and the mifepristone group, such as, menorrhagia (RR= 0.49, 95%CI 0.25 to 0.94), dysmenorrheal (RR= 0.12, 95%CI 0.04 to 0.38), and bellyache and abdominal distension (RR= 0.28, 95%CI 0.12 to 0.62); d) In terms of the total effective rate, significant differences were noted between the experimental group and the mifepristone group (RR= 1.16, 95%CI 1.02 to 1.32); and e) Four trials reported the long-term follow-up results in which the experimental group was better than that in the control group.Conclusion The treatment of uterine myoma by Guizhifuling capsule plus mifepristone is superior to that by mifepristone alone in reducing uterine myoma volume, clinical symptom, and long-term follow-up results. Singly using Guizhifuling capsule is not inferior to western medicine. Further large-scale trials are required to define the role of Guizhifuling capsule in the treatment of uterine myoma.
Abstract: Objective To transplant the microencapsulated recombinanted Chinese hamster ovary (CHO ) cells into the infracted myocardium of rodent animals and investigate whether vascular endothelial growth factor (VEGF) secreted by the implanted CHO cells could augment angiogenesis and improve cardiac function. Methods The cDNA of VEGF was transferred into CHO cells with plasmid stable transfection. After microencapsulation, the cell growth in microcapsules and the VEGF level in the culture supernatant were evaluated. Two weeks after myocardial infarction, the microencapsulated CHO cells (MC-CHO group ) were implanted into the border of infracted myocardium, as well as similar amount of CHO cells (CHO group ) , blank microcapsule (MC group ) and non-serum culture medium (control group ) as controls, 12 rats per group. The cardiac function improvement was evaluated 3 weeks after transplantation, while the survival status of implanted CHO cells, in situ secretion of VEGF and capillary density were assayed by histology. Results CHO cells could grow and proliferate after microencapsulation. The secretion of VEGF was detectable in culture media supernatant, with the highest concentration of 3 852 pg/m l at day 8. As compared to the other three groups, the left ventricular dimension and cardiac function were significantly improved in MC-CHO group 3 weeks after transplantation. The capillary density of MC-CHO group were increased significantly than those of CHO group, MC group and control group (22. 3±3. 1 vs. 15. 6±2. 8, 11. 4±2. 5, 13. 2±2. 7 vessels per 0.13 mm2, P lt; 0.05). The implanted microcapsule maintained its original shape and protected theCHO cells in it. Conclusion M icroencapsulaed recombinanted CHO cells transplantation might be a promising app roach to augment angiogenesis and improve the cardiac function in infarction myocardium.
ObjectiveTo evaluate the short-term effectiveness of arthroscopically capsular vertical mattress suturing for shoulder recurrent anterior dislocation combined with joint laxity.MethodsA retrospective analysis was performed on 6 shoulder recurrent anterior dislocation patients combined with joint laxity treated with arthroscopically capsular vertical mattress suturing between January 2017 and December 2018. There were 5 males and 1 female with an average age of 20.8 years (range, 19-24 years). The number of shoulder dislocation was 3-18 times, with an average of 9.5 times. The disease duration ranged from 2 to 60 months, with an average of 25.3 months. The preoperative Beighton score was 4-7, with an average of 5.8; the Instability Severity Index Score (ISIS) was 2-5, with an average of 3.5. There were 5 cases of simple Bankart injury and 1 case of bony Bankart injury. The range of motion of shoulder joint (including active flexion and lifting, external rotation, abduction and external rotation, and internal ratation) was recorded before operation and at last follow-up; Oxford shoulder instability score, Rowe shoulder instability score, and Simple Shoulder Test (SST) score were used to evaluate shoulder joint function before operation, at 6 months after operation, and at last follow-up, and complications were recorded.ResultsAll patients were followed up 16-28 months (mean, 19.3 months). During the follow-up, all patients had satisfactory motor function, and no re-dislocation and postoperative neurovascular complications occurred. At last follow-up, the activities of active external rotation and abduction and external rotation were significantly improved when compared with those before operation (P<0.05); the activities of active flexion and lifting and internal rotation were not limited before and after operation, and the difference was not significant (P>0.05). The Oxford shoulder instability score, Rowe shoulder instability score, and SST score at 6 months after operation and at last follow-up were significantly improved when compared with those before operation (P<0.05); there was no significant difference between at 6 months after operation and at last follow-up (P>0.05).ConclusionThe treatment of shoulder recurrent anterior dislocation combined with joint laxity by arthroscopically vertical matress suturing can achieve good short-term effectiveness.
ObjectiveTo systematically review the efficacy and safety of Heluo Shugan capsule in the treatment of hepatitis B fibrosis. MethodWe searched PubMed, The Cochrane Library (Issue 8, 2015), CBM, CNKI, VIP and WanFang Data from their inception to August 2015, to collect randomized controlled trials (RCTs) on Heluo Shugan capsule for hepatitis B fibrosis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 15 RCTs involving 1 840 patients were included. The results of meta-analysis showed that: (1) As for reduced level of serum hyaluronic acid (HA), Heluo Shugan capsule was superior to placebo (MD=82.31, 95%CI 37.44 to 127.19, P=0.000 3), but worse than Fuzheng Huayu capsule (MD=-137.45, 95% CI-196.29 to-78.62, P < 0.000 01), Fufang Biejia Ruangan tablet (MD=-51.19, 95% CI-67.58 to-34.81, P < 0.000 01) and Anti-fibrosis decoction (MD=-82.13, 95% CI-102.37 to-61.88, P < 0.000 01). (2) As for reduced level of serum laminin (LN), Heluo Shugan capsule was superior to placebo (MD=36.83, 95% CI 11.84 to 61.82, P=0.004), but worse than Fufang Biejia Ruangan tablet (MD=-36.00, 95% CI-64.29 to-7.71, P=0.01), Ganfujian capsule (MD=-22.14, 95% CI-37.28 to-7.00, P=0.004) and Anti-fibrosis decoction (MD=-38.64, 95% CI-75.00 to-2.29, P=0.04). (3) As for reduced level of serum procollagen type III peptide (PCIII), Heluo Shugan capsule was superior to placebo (MD=47.17, 95% CI 32.68 to 61.66, P < 0.000 01), but worse than Fuzheng Huayu capsule (MD=-4.80, 95% CI-9.08 to-0.51, P=0.03), Dahuang Zhechong pills (MD=-53.77, 95% CI-105.01 to-2.53, P=0.04), Ganfujian capsule (MD=-46.82, 95% CI-66.30 to-27.34, P < 0.000 01) and Anti-fibrosis decoction (MD=-28.68, 95% CI-55.59 to-1.77, P=0.04). (4) As for reduced level of serum type-IV-collagen (IV-C), Heluo Shugan capsule was superior to placebo (MD=72.77, 95% CI 47.65 to 97.89, P < 0.000 01), but worse than Fuzheng Huayu capsule (MD=-34.69, 95% CI-56.65 to-12.73, P=0.002), Dahuang Zhechong pills (MD=-21.26, 95%CI-38.79 to-3.73, P=0.02), Fufang Biejia Ruangan tablet (MD=-69.04, 95%CI-124.38 to-13.69, P=0.01), Ganfujian capsule (MD=-19.84, 95% CI-37.41 to-2.27, P=0.03) and Anti-fibrosis decoction (MD=-37.98, 95% CI-72.99 to-2.96, P=0.03). ConclusionCurrent evidence shows that, Heluo Shugan capsule was superior to placebo, but worse than Fufang Biejia Ruangan tablet, Fuzheng Huayu capsule, Dahuang Zhechong pills, Ganfujian capsule and Anti-fibrosis decoction in reducing the level of serum hepatic fibrosis. Due to the limited quantity and quality of included studies, more high-quality, large-scale RCTs are need to verify the above conclusion.