A systematic review and meta‐analysis of randomized controlled trials: Skin‐patch of Chinese herbal medicine for patients with acute gouty arthritis

Aims

To evaluate the evidence of the effectiveness and safety of Chinese herbal medicine skin‐patches for patients with acute gouty arthritis.

Background

Acute gouty arthritis is a problem that can limit the level of activity and impair the quality of life. In China, many clinical studies have demonstrated that skin‐patches of Chinese herbal medicines benefit patients with acute gouty arthritis. However, the reported clinical effects vary.

Design

A systematic review and meta‐analysis of randomized controlled trials.

Data sources

Three English databases including CENTRAL (1993 to February 2017), PubMed (1966 to February 2017) and EMBASE (1974 to February 2017) and four Chinese databases including Chinese National Knowledge Infrastructure, Chinese VIP Information, SinoMed and Wanfang (all, 1949 ‐ February 2017) were searched. Randomized controlled trials that compared skin‐patches of Chinese herbal medicine with or without conventional treatments to conventional treatments, no treatment or a placebo treatment for patients with acute gouty arthritis were included.

Review methods

We conducted a systematic review and meta‐analysis following the Cochrane process. Two authors selected the studies, extracted the data and evaluated the risk of bias of the included trials.

Results

Nineteen studies met our inclusion criteria. After synthesizing the data, the results showed that skin‐patches of CHM combined with Western medicine seemed to be more effective than Western medicine alone for pain relief in patients with acute gouty arthritis and had fewer adverse events.

Conclusion

Due to the quality of the data, larger and more rigorously designed clinical trials with proper outcome measures are necessary.     

Superlattice-like structure and enhanced ferroelectric properties of intergrowth Aurivillius oxides

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties. In this work, Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ and Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ compounds were successfully synthetised using a simple solid-state reaction method. X-Ray diffraction patterns and scanning transmission electron microscopy high angle annular dark field (STEM-HAADF) images confirm the 2–3 and the 3–4 intergrowth structures in Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ compounds, respectively. A superlattice-like distortion in these oxides was proposed resulting from the combination of sub-lattices with different a and b parameters, which was validated by XRD refinements and Raman spectra. Polarization-electric field tests and pulsed polarization positive-up negative-down measurements demonstrate that such superlattice-like structures can effectively enhance the intrinsic ferroelectric polarization and coercive field of these oxides, especially when compared with their component oxides Bi₃TiNbO₉, Bi₃LaTiNbFeO₁₂ and Bi₅Ti₃FeO₁₅. Simultaneously, ferroelectric Curie temperatures of Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ oxides are lowered because of the internal stress in the superlattice-like structure. Nevertheless, the paramagnetism of the samples is hardly influenced by their structure, while mainly related to their iron content, in which iron has a similar effective magnetic moment around 3.4–3.9.

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties.     

橡皮圈腔内牵拉法在内镜黏膜下剥离术中辅助价值研究

目的　评价橡皮圈腔内牵拉法用于内镜黏膜下剥离术（endoscopic submucosal dissection,ESD） 中的有效性及安全性。方法　纳入2016年1月—2019年12月因直肠内分泌瘤就诊于首都医科大学附属北京友谊医院的49例患者,其中2016年1月—2018年5月行常规ESD的患者32例（非牵拉组）,2018年6月—2019年12月行橡皮圈腔内牵拉ESD的患者17例（牵拉组）,比较2组患者基本信息、ESD手术时间、并发症等指标。结果　牵拉组和非牵拉组在年龄、性别及病变大小方面差异均无统计学意义（P均>0.05）。牵拉组ESD操作时间为（13.76±5.71） min,非牵拉组ESD操作时间为（22.99±10.32） min,两者差异有统计学意义（t=-3.408,P=0.001）。牵拉组未发生术后并发症,非牵拉组有3例出现穿孔,但穿孔发生率差异无统计学意义（P=0.542）。结论　橡皮圈腔内牵拉法辅助ESD,可以安全完成ESD操作并有效提高剥离效率。     

江苏省医院非技术服务质量评价指标体系的研究

非技术性服务质量对于现代医院来讲意义重大。评价指标体系是对其进行评价而改进其质量为前提和关键。该研究从指标体系的构建、指标体系的确立以及指标体系的考核三个方面研究了江苏省医院非技术服务质量评价指标体系。     

中西医结合治疗脑卒中后焦虑障碍45例临床研究

目的：观察中西医结合治疗脑卒中后焦虑障碍（PSAD）的临床疗效。方法；对45例PSAD病人于治疗前后进行SAS测评，并对所获资料进行统计学分析。结果：焦虑症状消失率为88．89％；SAS标准分均数值经治疗后明显下降，有统计学意义（P＜0．001）；各项目所引起的症状得分均数值亦明显下降。结论：中西医结合治疗PSAD可取得较好疗效。     

青海省鼠疫患者血清抗体谱研究

目的研究在鼠疫感染过程中,患者对鼠疫耶尔森菌产生体液免疫反应的规律.寻找鼠疫菌新的具有免疫原性的蛋白。方法利用鼠疫耶尔森菌重要毒力相关蛋白芯片对鼠疫患者的血清抗体谱进行检测。结果利用含145个鼠疫耶尔森菌蛋白质的蛋白芯片。共检测到鼠疫患者血清中29个蛋白的抗体。其中13种蛋白的抗体在患者体内明显上升,除已知的8个具有免疫原性的蛋白外,发现了鼠疫菌5个新的具有免疫原性的蛋白(SycE、SycH、OmpA、pH6与YPO2098)。结论这5个新的具有免疫原性的蛋白将是下一步鼠疫疫苗研究的靶点。     

中药扶正抗癌方治疗中、晚期消化道肿瘤160例临床观察

14年来，以中药扶正抗癌方（自拟）治疗中、晚期消化道肿瘤160例，收到了较为满意的疗效。患者症状改善，血象升高，免疫指标提升，癌胚抗原含量下降．患者的体质增强，体重增加．其它疾病少发等，有的患者癌灶缩小，甚至消失，绝大多数的患者经治疗后生存期得以延长。     

苍脂颗粒剂对鼠胃粘膜细胞保护作用的研究

为了探讨苍脂颗粒剂治疗脾胃病的胃粘膜保护作用，采用利血平模拟的大鼠脾虚证及亚急性阿斯匹林胃粘膜损伤模型，测定其对非蛋白质流基物质（NPSH）、谷胱甘肽过氧化物酶（GSH－px）、过氧化氢酶（CAT）、超氧化物歧化酶（SOD）及血浆过氧化脂质（LPO）等具有胃粘膜细胞保护作用物质的含量或活性的影响。结果显示，苍脂颗粒剂可以明显改善脾虚伴慢性胃粘膜病变大鼠及亚急性阿期匹林胃粘膜损伤大鼠的粘膜损伤程度，显著提高胃粘膜NPSH（F＜0．01）、GSH-px（P＜0．01）等细胞保护物质的水平．提示苍脂颗粒剂具有一定的胃粘膜细胞保护作用。     

Acute allograft rejection and immunosuppression: influence on endogenous melatonin secretion

Abstract: Melatonin displays a dose‐dependent immunoregulatory effect in vitro and in vivo. Exogenous high‐dose melatonin therapy exerted an immunosuppressive effect, abrogating acute rejection (AR), significantly prolonging transplant survival. Endogenous melatonin secretion, in response to heterotopic rat cardiac allograft transplantation (Tx), was investigated during the AR response and under standardized immunosuppressive maintenance therapy with cyclosporin A (CsA) and rapamycin (RPM). Recipients of syngeneic transplants, and recipients of allogeneic grafts, either untreated or receiving immunosuppressive therapy constituted the experimental groups. Endogenous circadian melatonin levels were measured at 07:00, 19:00, and 24:00 hr, using a novel radioimmunoassay (RIA) procedure, under standardized 12‐hr‐light/dark‐conditions (light off: 19:00 hr; light on: 07:00 hr), before and after Tx. Neither the operative trauma, nor the challenge with a perfused allograft or the AR response influenced endogenous melatonin peak secretion. Immunosuppressive therapy with CsA led to a significant increase in peak secretion, measured for days 7 (212 ± 40.7 pg/mL; P < 0.05), 14 (255 ± 13.9 pg/mL; P < 0.001), and 21 (219 ± 34 pg/mL; P < 0.01) after Tx, as compared with naïve animals (155 ± 25.8 pg/mL). In contrast, treatment with RPM significantly decreased the melatonin peak post‐Tx up to day 7 (87 ± 25.2 pg/mL; P < 0.001), compared with naïve animals (155 ± 25.8 pg/mL). These findings imply a robust nature of the endogenous circadian melatonin secretion kinetics, even against the background of profound allogeneic stimuli. Immunosuppressive maintenance therapy with CsA and RPM modulated early melatonin secretion, indicating a specific secondary action of these drugs. Further studies are necessary to disclose the long‐term effect of immunosuppressive therapy on circadian melatonin secretion in transplant recipients.