Chemotherapy in alveolar echinococcosis of multi-organs: what’s the role?

The aim of this study was to investigate the clinical efficiency of chemotherapy for the treatment of human alveolar echinococcosis (AE). Twenty-four patients who suffered from late-stage AE were enrolled in this study. The classification of the disease stages was performed according to the PNM (parasite lesion, neighboring organ invasion, metastases) classification system established by the World Health Organization Informal Working Group on Echinococcosis and classification standards. Radical surgery (n?=?3), palliative surgery plus chemotherapy (n?=?11), and sole chemotherapy (n?=?10) were given, respectively. For those with AE metastasis with spleen and kidney, radical surgery was effective for the treatment. However, the treatment efficiency for those with AE metastasis to bone tissues was unfavorable. Significant improvement was noted in those with cerebral lesions after chemotherapy. Stable health conditions were observed in those with pulmonary lesions after chemotherapy. For those with liver lesion, long stable health conditions were noted after chemotherapy. However, surgical interventions were needed as the occurrence of bile duct complications. With regards to the other lesions, radical surgeries were recommended. Satisfactory treatment outcomes were obtained in those with AE after chemotherapy.     

竹筏原理在Pilon骨折中的应用

目的 总结利用竹筏原理,采用T 形锁定板和苜蓿钢板治疗Pilon 骨折的经验.方法 36 例Pilon骨折患者按Ruedi-Allgower 分型,达Ⅱ型19 例,Ⅲ型17 例,均采用切开复位,L 形锁定板或苜蓿钢板内固定术.结果 治疗后,临床疗效优良率80.6%,其中Ⅱ型达84.2%,Ⅲ型达76.5%.结论 利用竹筏原理,采用L 形锁定板或苜蓿钢板治疗Pilon 骨折,具有固定稳定性可靠,有利于骨折愈合和早期关节负重的优点,其远期疗效有待于进一步讨论.     

Application of Zhitong Rushen Gauze for Hemorrhoidectomy 30 Cases in Hyperacute Phase

目的 探讨止痛如神油纱在痔术后超早期应用的效果.方法 将30例病人分为治疗组15例和对照组15例.治疗组使用止痛如神油纱术后肛门纳入,对照组使用常规凡士林油纱,比较两组的术后并发疼痛和出血情况.结果 治疗组术后疼痛轻,且未见明显不良反应.结论 止痛如神油纱早期应用防治术后并发症效果满意,安全性高,值得临床推广.     

Oligometastatic recurrence of an oesophageal adenocarcinoma at a chest drain site following radical treatment: palliative treatment or resection?

A 62-year-old female patient diagnosed with oesophageal adenocarcinoma underwent radical treatment consisting of neoadjuvant chemotherapy and oesophagectomy with no major complications. Eleven months later, she re-presented with a mass at one of the chest drain sites. A PET-CT scan and biopsy demonstrated this to be a single recurrence of the oesophageal adenocarcinoma. Excision of the metastatic lesion was considered as per metachronous single site metastasis. However, the operation was postponed due to acute kidney injury. Restaging after 6 weeks revealed progressive metastatic disease. The patient underwent palliative therapy and passed away soon after. Oesophageal cancer recurrence has a very poor prognosis, and factors such as the disease-free interval, site of recurrence and tumour pathological factors must be considered when stratifying for suitability for metastasectomy. A period of watchful waiting followed by restaging is essential to rule out patients with indolent metastatic disease.     

A Bayesian Meta-analysis Method for Estimating Risk Difference of Rare Events

Bayesian meta-analysis has been more frequently utilized for synthesizing safety and efficacy information to support landmark decision-making due to its flexibility of incorporating prior information and availability of computing software. However, when the outcome is binary and the events are rare, where event counts can be zero, conventional meta-analysis methods including Bayesian methods may not work well. Several methods have been proposed to tackle this issue but the prior knowledge of event rate was not utilized to increase precision of risk difference estimates. To better estimate risk differences, we propose a new Bayesian method, Beta prior BInomial model for Risk Differences (B-BIRD), which takes into account the prior information of rare events. B-BIRD is illustrated using a real data set of 48 clinical trials about a type 2 diabetes drug. In simulation studies, it performs well in low event rate settings.     

一重与多重脑震荡大鼠伤后14 d的焦虑行为变化

  目的  观察一重与多重脑震荡（multiple cerebral concussion，MCC）大鼠的焦虑行为变化。  方法  成年SD大鼠50只，用单摆闭合性脑损伤打击装置复制大鼠一重脑震荡（pure cerebral concussion，PCC）和多重脑震荡（multiple cerebral concussion，MCC）模型，另设一正常对照组（normal，N）每组12只大鼠。于损伤后第14天进行旷场实验（open field test，OFT）和高架十字迷宫实验（high plus maze，HPM）检测，评估其焦虑行为变化。  结果  （1）在OFT实验中:① PCC组和3 MCC组在中央区行走格数为[9.500（6.50，16.75）]格、[5.00（3.50，9.00）]格，N组为[10.00（7.00，17.88）]格。损伤组在中央区行走的格数与停留时间均少于对照组，3 MCC组与N组、PCC组比较差异有统计学意义，P < 0.05（P = 0.024，P = 0.033）。② PCC组和3 MCC组在周边区行走格数为[54.50（26.88，62.25）]格、[65.00（28.50，81.00）]格，N组为[33.00（1.13，51.50）]格。损伤组在周边区（surround areas，SA）行走格数和时间均高于对照组，3 MCC组与N组比较差异有统计学意义，P < 0.05（P = 0.015）。③ PCC组和3 MCC组梳理毛发频次为（4.20±1.03）次、（2.44±0.73）次，N组为（5.20±1.62）次。损伤组梳理毛发次数均少于N组，且3 MCC组较N组与PCC组差异有统计学意义，P < 0.05（P = 0.013，P = 0.019）。④各损伤组大鼠在旷场实验中CA区行走格数、行走时间与理毛次数，均随着打击次数的增加呈现下降趋势。此外，随着打击次数的增加，损伤大鼠在SA区行走格数与行走时间则呈上升趋势。（2）在HMP实验中:① PCC组和3 MCC组进入开臂次数为[1.00（0.00，1.00）]次、[0.50（0.00，1.00）]次，N组为[1.00（0.00，2.00）]次。各损伤组进入开臂（open arms，OA）次数和时间均少于正常组，但各组间差异无统计学意义，P > 0.05。②损伤组在OA中向台下探索次数均少于N组，其中3 MCC组差异有统计学意义，P < 0.05（P = 0.032）。③ PCC组和3 MCC组进入闭臂次数为[1.00（1.00，1.00）]次、[0.00（0.00，1.00）]次，N组为[0.00（0.00，1.00）]次。损伤组进入闭臂（enclosed arms，EA）次数与时间均高于N组，进入EA次数，3 MCC组与PCC组比较，差异具有统计学意义，P < 0.05（P = 0.015）；进入EA时间，3 MCC组与N组、PCC组比较差异有统计学意义，P < 0.05（P = 0.042，P = 0.027）。④各损伤组大鼠在高架十字迷宫实验中，进入OA臂的次数、时间与向台下探望次数，均随着打击次数的增加呈现下降趋势。此外，随着打击次数的增加，损伤大鼠在EA臂中的停留时间则呈上升趋势。  结论  一重和三重脑震荡大鼠损伤后14 d焦虑行为开始明显增加，且大鼠经历三次脑震荡后的焦虑行为重于一次性脑震荡。     

Establishment of safety evidence for Xingxue Shuxuening injection

OBJECTIVE： To systematically investigate the safety of Xingxue Shuxuening injection（SXN） in preand post-marketing, and to ensure clinical drug safety.METHODS： Strict quality control in raw herb selection and production processes was adopted and pharmacology research on SXN was performed by the drug manufacturing company, Heilongjiang ZBD Pharmaceutical Co., Ltd. We systematically reviewed the safety literature of Xingxue SXN. Adverse drug reaction（ADR） data of the drug, extracted from Spontaneous Reporting System（SRS）, and clinical characters based on 20 hospital information systems（HIS） in China, were analyzed. Large-scale prospective safety monitoring and Risk Minimization Action Plans（Risk MAPs） of XingxueSXN were carried out.RESULTS： The quality of SXN was stable and controllable when it was produced. Drug toxicology studies found no effect on rabbits with hemolytic or condensed, local stimulation and muscle stimulation, and no allergic reactions in guinea pigs. The ADRs of Xingxue SXN were dizziness, phlebitis,and vomiting based on SRS data. The injection did not conform to instructions in clinical practice when we analyzed HIS database, and patient＇s abnormal blood urea nitrogen levels may be related to the drug, when analyzed using the propensity score method. A nested case-control study was designed and performed to analyze the influencing factors of suspected allergic reactions to SXN. The study showed that patients with an allergy history were more prone to allergic reactions（P〈0.001）,and some medicine combinations could cause allergic reactions.CONCLUSION： These studies have established a body of evidence on Xingxue SXN safety, and provide a good model for Chinese medicine injection for clinical safety. The Xingxue SXN production process and toxicology research indicate the safety of the injection. However, the use of the injection is not consistent with instructed clinical practice.Xingxue SXN causes ADRs perhaps from inappropriate usage or its     

Effect of estrogen on regression of vascular calcification in rats

Objective To investigate the effect of estrogen on regression of vascular calcification in rats induced by vitamin D3 plus nicotine. Methods Ninety?six female SD rats were divided randomly into control group (n=24) and calcification group (n=72). Vascular calcification of 72 rats was induced by vitamin D3 and nicotine (VDN). On the day 1, the VDN group rats were injected with vitamin D3(300 000 U/kg, i.m), and were intragastric administrated with nicotine (25 mg/kg), after 9 hours, another dosage of nicotine was given again. After 4 weeks, the VDN group rats were subdivided randomly into 4 groups: VDN group(n=16), Sham operation group (n=16), ovariotomy group (n=16), estrogen group(after ovariotomy, 17β ?estrogen was subcutaneously injected, 50 μg•kg-1•d-1, n=16). Results After 4 weeks，the VDN group showed obvious vascular calcification, and calcium content of the vessel wall was significantly higher than that of control group (P<0.01). Extensive calcification was witnessed on the aortic tunica media of the VDN group. After 12 and 8 weeks, the calcium content of the vessel wall in each subdivided groups was significantly lower than that at 4 weeks point(P<0.01), and the lowest calcinm content was in estrogen group, meanwhile the reduction of previously accumulated arterial calcium precipitate in each group was different. Conclusions It is a reversible process that vascular calcification induced by vitamin D plus nicotine in rats. Estrogen can promote the regression of vascular calcification.