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Background:Gastrointestinal complications and malnutrition are common problems that affect postoperative rehabilitation and survival of patients with esophageal cancer. Evidence has shown that probiotics have a positive effect on improving gastrointestinal complications and nutritional status of patients with esophageal cancer after surgery, but there is a lack of prospective studies on this topic. We designed this prospective randomized controlled trial to evaluate the effects of probiotics on gastrointestinal complications and nutritional status in patients with postoperative esophageal cancer.Methods:This is a prospective, randomized, double-blind, placebo-controlled trial. It was approved by the Clinical Research Ethics Committee of our hospital. 192 patients will be randomly divided into probiotics group and the placebo group in a 1:1 ratio. After operation, probiotics and placebo will be given orally for 8 weeks. The indexes of nutritional status and incidence of digestive tract complications will be recorded and the data will be analyzed by SPSS 18.0 software.Discussion:This study will evaluate the effect of probiotics on gastrointestinal complications and nutritional status of postoperative patients with esophageal cancer. The results of this study will provide clinical basis for the use of probiotics in postoperative treatment of esophageal cancer.Trial registration:OSF Registration number: D DOI 10.17605/OSF.IO/QHW86 相似文献
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《Journal of diabetes and its complications》2020,34(11):107706
AimsType 2 diabetes (T2D) accelerates progression of chronic liver disease to cirrhosis, yet the effects of most glucose-lowering drugs (GLDs) on cirrhosis risk in T2D are unknown. To address this gap, we compared cirrhosis risk following initiation of newer second-line GLDs vs. thiazolidinediones (TZDs), which improve histology in non-alcoholic fatty liver disease.Materials and methodsUsing the US Medicare Fee-for-Service database (2007–2015) and an active comparator, new-user design, we estimated crude incidence rates (IRs) and propensity-score adjusted hazard ratios (aHR) for incident cirrhosis, comparing newer GLDs (dipeptidyl peptidase-4 inhibitors (DPP4i), glucagon-like peptide-1 receptor agonists (GLP1RA), and sodium-glucose co-transporter 2 inhibitors (SGLT2i)) vs. TZDs.ResultsAmong 239,549 total initiators, we observed 318, 151, and < 30 cirrhosis events when comparing DPP4i vs. TZD, GLP1RA vs. TZD, and SGLT2i vs. TZD, respectively. IRs ranged from 1.7 [95% CI, 0.8–3.6] to 3.6 [2.5–5.2] events per 1000 person-years. Point aHR estimates for cirrhosis were elevated among newer GLD initiators vs. TZD (DPP4i: 1.15 [0.89–1.50]; GLP1RA: 1.34 [0.82–2.20]; SGLT2i: 1.16, [0.44–3.08]), although estimates were imprecise due to short durations of drug exposure.ConclusionsWe observed mildly elevated cirrhosis risk with newer GLDs vs. TZD; however, uncertainty remains due to imprecise and statistically non-significant effect estimates. 相似文献
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Some implications from a simplified finite-element model are given in this study. The model takes into account the sequential steps of wound contraction, angiogenesis and wound closure. An innovation in the present study is the combination of these partially overlapping processes, yielding novel insights into the process of wound healing, such as geometry related influences, and could be used to investigate the influence of local injection of hormones that stimulate partial processes occurring during wound healing. These insights can be used to improve wound-healing treatments. The model consists of nonlinearly coupled diffusion–reaction and visco-elastic equations, in which transport, production and decay of oxygen, growth factors and various cell types. The present paper provides results of the healing of deep wounds under several regimes of endothelial and epithelial cell migration, and the results are interpreted in a biological sense. 相似文献
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Zhihong Li Shuqin Guo Fang Yao Yunliang Zhang Tingting Li 《Journal of diabetes and its complications》2013,27(4):380-382
ObjectiveLittle is known about serum concentrations of Matrix Metalloproteinase-9 (MMP-9), MMP-2, TIMP-1 and TIMP-2 in diabetic patients with foot ulcers. This study demonstrates their relationship with wound healing.MethodsNinety-four patients with diabetic foot ulcers were recruited in the study. Serum MMP-9, MMP-2, TIMP-1 and TIMP-2 were measured at the first clinic visit and the end of 4-week treatment and followed up till 12 weeks. According to the decreasing rate of ulcer healing area at the fourth week, we divided those cases into good and poor healers. Through analyses, we explore the possible relationship among those factors and degree of wound healing.ResultsThe median level of serum MMP-9 in good healers was lower than poor healers at first visit (124.2 μg/L vs 374.6 μg/L, p < 0.05), and after 4-week therapy it decreased 5-fold approximately. In contrast, the change in MMP-9 concentration did not reach statistical significance in poor healers. MMP-2, TIMP-1 and TIMP-2 varied slightly in both good healers and poor healers. The MMP-9/TIMP-1 ratio better reflected the healing than MMP-9 alone before therapy and after 4 week treatment (r = ? 0.6475 vs ? 0.3251, r = ? 0.7096 vs ? 0.1231, respectively). Receiver Operator Curve (ROC) showed that the cutoff for MMP-9/TIMP-1 ratio at < 0.395 best predicted a reduction in wound area of 82% at the end of 4-week treatment with a sensitivity of 63.6% and a specificity of 58.6% (area under the curve 0.658, p < 0.001).ConclusionsDetecting serum MMP-9/TIMP-1 ratio on admission might be a predictor of healing and might provide a novel target for the future therapy in diabetic foot ulcers. 相似文献
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Xiaoliang Bai Yong Lian Jie Wang Hongxin Zhang Meichao Jiang Hao Zhang Bo Pei Changqing Hu Qiang Yang 《Medicine》2021,100(9)
Objective:This meta-analysis was performed to investigate whether percutaneous endoscopic lumbar discectomy (PELD) had a superior effect than other surgeries in the treatment of patients with lumbar disc herniation (LDH).Method:We searched PubMed, Embase, and Web of Science through February 2018 to identify eligible studies that compared the effects and complications between PELD and other surgical interventions in LDH. The outcomes included success rate, recurrence rate, complication rate, operation time, hospital stay, blood loss, visual analog scale (VAS) score for back pain and leg pain, 12-item Short Form Health Survey (SF12) physical component score, mental component score, Japanese Orthopaedic Association Score, Oswestry Disability Index. A random-effects or fixed-effects model was used to pool the estimate, according to the heterogeneity among the included studies.Results:Fourteen studies (involving 2,528 patients) were included in this meta-analysis. Compared with other surgeries, PELD had favorable clinical outcomes for LDH, including shorter operation time (weight mean difference, WMD=−18.14 minutes, 95%CI: −25.24, −11.05; P < .001) and hospital stay (WMD = −2.59 days, 95%CI: −3.87, −1.31; P < .001), less blood loss (WMD = −30.14 ml, 95%CI: −43.16, −17.13; P < .001), and improved SF12- mental component score (WMD = 2.28, 95%CI: 0.50, 4.06; P = .012)) and SF12- physical component score (WMD = 1.04, 95%CI: 0.37, 1.71; P = .02). However, it also was associated with a significantly higher rate of recurrent disc herniation (relative risk [RR] = 1.65, 95%CI: 1.08, 2.52; P = .021). There were no significant differences between the PELD group and other surgical group in terms of success rate (RR = 1.01, 95%CI: 0.97, 1.04; P = .733), complication rate (RR = 0.86, 95%CI: 0.63, 1.18; P = .361), Japanese Orthopaedic Association Score score (WMD = 0.19, 95%CI: −1.90, 2.27; P = .861), visual analog scale score for back pain (WMD = −0.17, 95%CI: −0.55, 0.21; P = .384) and leg pain (WMD = 0.00, 95%CI: −0.10, 0.10; P = .991), and Oswestry Disability Index score (WMD = −0.29, 95%CI: −1.00, 0.43; P = .434).Conclusion:PELD was associated with better effects and similar complications with other surgeries in LDH. However, it also resulted in a higher recurrence rate. Considering the potential limitations in the present study, further large-scale, well-performed randomized trials are needed to verify our findings. 相似文献
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《Journal of diabetes and its complications》2020,34(2):107448
Aim of the StudyDuring type 2 diabetes (T2D) and hypertension there is stimulation of renal proximal tubule angiotensinogen (AGT), but whether urinary excretion of AGT (uAGT) is an indicator of glomerular damage or intrarenal RAS activation is unclear. We tested the hypothesis that elevations in uAGT can be detected in the absence of albuminuria in a mouse model of T2D.MethodsMale C57BL/6 mice (N = 10) were fed a high fat (HFD; 45% Kcal from fat) for 28 weeks, and the metabolic phenotype including body weight, blood pressures, glucose, insulin, ippGTT, HOMA-IR, and cholesterol was examined. In addition, kidney Ang II content and reactive oxygen species (ROS) was measured along with urinary albumin, creatinine, Ang II, and AGT.ResultsAll parameters consistent with T2D were present in mice after 12–14 weeks on the HFD. Systolic BP increased after 18 weeks in HFD but not NFD mice. Intrarenal ROS and Ang II concentrations were also increased in HFD mice. Remarkably, these changes paralleled the augmentation uAGT excretion (3.66 ± 0.50 vs. 0.92 ± 0.13 ng/mg by week 29; P < 0.01), which occurred in the absence of overt albuminuria.ConclusionsIn HFD-induced T2D mice, increases in uAGT occur in the absence of overt renal injury, indicating that this biomarker accurately detects early intrarenal RAS activation. 相似文献
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《Journal of diabetes and its complications》2020,34(11):107708
AimsMonocytes and macrophages express cell-surface markers indicative of their inflammatory and activation status. In this study, we investigated whether these markers are affected or correlated in non-obese T2D subjects, or glycemic/metabolic control variables.MethodsClinical data was recorded, and peripheral blood drawn from T2D patients (n = 28) and control subjects (n = 27). Isolated monocytes were evaluated by flow cytometry for the expression of CD14, CD16, and the phenotypic markers for the different states of activation spectrum, such as pro-inflammatory (M1) (HLA-DR, CD86), anti-inflammatory/pro-resolving (M2) (CD163, CD206, MERTK, PD-L1) and metabolically-activated (MMe) (CD36, ABCA-1). From a subset of individuals, monocytes-derived macrophages (MDM) were obtained and evaluated for phenotypic markers. A correlation analysis was performed between the clinical variables and the marker expression.ResultsThe frequency of CD14++CD16− monocytes was lower in T2D patients and it correlates negatively with poor control in glycemic and metabolic variables. T2D monocytes expressed lower levels of HLA-DR, CD86, PD-L1, and CD163, which correlated negatively with poor metabolic control. In MDM from T2D patients, HLA-DR, CD86 and CD163 expression was lower and it inversely correlated with deficient glycemic or metabolic control parameters.ConclusionThe glycemic/metabolic control associated with T2D influences monocyte and MDM phenotypes toward an immune-suppressive phenotype. 相似文献
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目的 观察苏合香丸联合氯吡格雷治疗急性脑梗死的临床疗效。方法 选取2020年12月—2022年1月保定市第二医院收治的98例急性脑梗死患者,随机数字表法将所有患者分为对照组和治疗组,每组各49例。对照组口服硫酸氢氯吡格雷片,75 mg/次,1次/d。治疗组在对照组基础上口服苏合香丸,1丸/次,2次/d。两组疗程均为2周。观察两组的临床疗效,比较两组卒中相关量表评分,血小板相关参数[血小板最大聚集率(MAR)、血浆血小板α颗粒膜糖蛋白(CD62p)、溶酶体膜糖蛋白(CD63)、血栓素B2(TXB2)水平]及血浆纤维蛋白原(FIB)、D-二聚体(D-D)、S100β蛋白和脑源性神经营养因子(BDNF)水平。结果 治疗后,治疗组总有效率是95.9%,显著高于对照组的83.7%(P<0.05)。治疗后两组欧洲卒中量表(ESS)评分均显著增加,美国国立卫生研究院卒中量表(NIHSS)评分均显著减少(P<0.05);且均以治疗组改善更显著(P<0.05)。治疗后,两组MAR和血浆CD62p、CD63、TXB2水平比治疗前均显著降低(P<0.05);且治疗后,治疗组MAR及血... 相似文献