The effect of Crataegus oxycantha Special Extract WS 1442 on clinical progression in patients with mild to moderate symptoms of heart failure

AIM: To examine whether hawthorn (Crataegus Special Extract WS 1442 {CSE}) inhibits progression in heart failure (HF) patients. METHODS: We performed a retrospective analysis of data from the HERB CHF study in which patients with mild to moderate HF were randomised to either CSE 900 mg or placebo for 6 months. The primary outcome was time to progression of HF (HF death, hospitalisation, or sustained increase in diuretics) as assessed by log-rank tests and by Cox modelling. RESULTS: Progression of HF occurred in 46.6% of the CSE and 43.3% of the placebo groups (OR 1.14, 95% CI=0.56, 2.35: p=0.86). Patients receiving CSE were 3.9 times (95% CI=1.1-13.7: p=0.035) more likely to experience HF progression at baseline. In adjusted analysis, the risk of having early HF progression in the CSE group increased to 6.4 (95% CI=1.5, 26.5: p=0.011). In patients with LVEF< or =35%, those taking CSE were at significantly greater risk (3.2, 95% CI=1.3, 8.3: p=0.02) than the placebo group. CONCLUSIONS: CSE does not reduce heart failure progression in patients who have HF. CSE appears to increase the early risk of HF progression.     

生物可降解聚合物微球的制备设备概况

概述了制备生物可降解微球的工艺设备及工作原理,如基于乳化法的改进方法、基于射流激发、电压驱动或"切割"成型的设备.     

滇龙胆草对肺纤维化小鼠肺组织NF-κB和CTGF表达的影响

  目的  研究滇龙胆草对肺纤维化小鼠肺组织NF-κB和CTGF表达的影响。  方法  气管滴注博莱霉素（5 mg/kg ）制备昆明小鼠肺纤维化模型，造模后灌胃给予低、中、高剂量（50、100、200 mg/kg）的滇龙胆草，每日给药1次，设比非尼酮为阳性对照。在建模后第28天，取肺组织进行检测，肉眼观察肺组织大体病理改变，Masson染色观察肺组织纤维化程度；采用Western blot检测肺组织中NF-κB和CTGF蛋白的表达。  结果  与模型组比较，不同剂量的滇龙胆草组和阳性药物比非尼酮组小鼠肺组织胶原沉积明显减少。与模型组比较，不同剂量的滇龙胆草组和阳性药物比非尼酮组小鼠肺组织NF-κB和CTGF蛋白表达明显下调，差异有统计学意义（P < 0.05）。  结论  滇龙胆草具有抗肺纤维化作用，其机制与下调NF-κB和CTGF蛋白表达，减轻肺组织炎症和胶原沉积有关。     

Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches

Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatment challenging. A vital step in treatment of such comorbidity is careful and comprehensive diagnostic assessment. We attempt to explain various psychosocial and pharmacological approaches for treatment of comorbid anxiety and depression. For the psychosocial component, we focus only on generalized anxiety disorder based on the following theoretical models: (1) “the avoidance model”; (2) “the intolerance of uncertainty model”; (3) “the meta-cognitive model”; (4) “the emotion dysregulation model”; and (5) “the acceptance based model”. For depression, the following theoretical models are explicated: (1) “the cognitive model”; (2) “the behavioral activation model”; and (3) “the interpersonal model”. Integration of these approaches is suggested. The treatment of comorbid anxiety and depression necessitates specific psychopharmacological adjustments as compared to treating either condition alone. Serotonin reuptake inhibitors are considered first-line treatment in uncomplicated depression comorbid with a spectrum of anxiety disorders. Short-acting benzodiazepines (BZDs) are an important “bridging strategy” to address an acute anxiety component. In patients with comorbid substance abuse, avoidance of BZDs is recommended and we advise using an atypical antipsychotic in lieu of BZDs. For mixed anxiety and depression comorbid with bipolar disorder, we recommend augmentation of an antidepressant with either lamotrigine or an atypical agent. Combination and augmentation therapies in the treatment of comorbid conditions vis-à-vis monotherapy may be necessary for positive outcomes. Combination therapy with tricyclic antidepressants, gabapentin and selective serotonin/norepinephrine reuptake inhibitors (e.g., duloxetine) are specifically useful for comorbid chronic pain syndromes. Aripiprazole, quetiapine, risperidone and other novel atypical agents may be effective as augmentations. For treatment-resistant patients, we recommend a “stacking approach” not dissimilar from treatment of hypertension In conclusion, we delineate a comprehensive approach comprising integration of various psychosocial approaches and incremental pharmacological interventions entailing bridging strategies, augmentation therapies and ultimately stacking approaches towards effectively treating comorbid anxiety and depression.     

钛夹预先蒂部结扎联合高频电切治疗大肠带蒂息肉的临床效果

目的:观察在内镜下切除大肠带蒂息肉时预先用钛夹在息肉蒂部结扎预防出血的临床效果.方法:选取2017年6月—2020年7月我院内镜中心收治的大肠息肉患者370例,随机分为试验组182例(息肉198枚),对照组188例(息肉222枚),试验组预先用钛夹在息肉蒂部结扎再行高频电切除术结合中医辨证施治治疗肠息肉,对照组单纯高频...     

肌上皮癌的研究进展

肌上皮癌（myoepithelial carcinoma,MC）是一种罕见的恶性肿瘤,发病部位以涎腺居多,随着免疫组织化学及病理学检查技术不断进步,国内外文献报道临床个案逐渐增多,除最常见的涎腺MC外,有关其他更为少见部位的MC个案病例报道越来越多。本文通过总结目前国内外相关文献报道的个案及研究,结合本院实际经验,综述MC的研究进展,内容包括病因、病理、临床特征、诊治进展以及各种少见部位的MC特征等,旨在为临床MC的诊治提供参考。      

甲状腺癌的超声误诊分析

目的分析甲状腺癌超声图像特征,降低超声误诊或漏诊率。方法总结术后病理确诊,超声误诊、漏诊的37例甲状腺癌声像图特征,进行声像图与病理对照回顾分析。结果病理诊断的37例甲状腺癌,乳头状癌28例,滤泡癌3例,髓样癌4例,鳞癌1例,转移癌1例。声像图分4型:①实质型;②实质并钙化型     

康复性训练对于运动员的重要性

康复性训练(prehabilitation)旨在预防运动员的运动性损伤。本文介绍了康复性训练的流程和方法。