Homeopathic Agents or Vitamins in Reducing Ecchymosis after Oculofacial Surgery: A Report by the American Academy of Ophthalmology

PurposeTo review the published literature to determine the efficacy and safety of homeopathic agents or vitamins in reducing ecchymosis after oculofacial surgery or laser surgery.MethodsA literature search was conducted in the PubMed database initially in December 2019 and updated in March 2020 to identify all studies in the English language literature on the use of homeopathic agents or vitamins in oculofacial procedures, including laser surgery. The search yielded 124 citations, and 11 articles met all inclusion criteria for this assessment. A panel methodologist then assigned a level of evidence rating for each study. Eleven studies met inclusion criteria; 9 were rated level I, and 2 were rated level III.ResultsThe agents studied in the articles identified included oral or topical Arnica montana (AM), oral Melilotus extract, topical vitamin K oxide, and topical AM combined with Rhododendron tomentosum. Metrics to describe ecchymosis varied. In 7 controlled studies, perioperative AM provided no or negligible benefit versus placebo. In 2 studies, vitamin K cream was equivalent to placebo. One study of oral Melilotus extract had less ecchymosis compared with controls in paranasal and eyelid ecchymosis at postoperative day (POD) 7, but not at PODs 1 and 4. A lone cohort study of combined topical AM and R. tomentosum lacked objective metrics and adequate controls. No serious side effects from administration of homeopathic agents or vitamins were identified.ConclusionsThe current literature does not support the use of AM, vitamin K oxide, R. tomentosum, or Melilotus extract for reducing ecchymosis after oculofacial surgery or pulsed dye laser surgery.     

Relief Effect of Bevacizumab on Severe Edema Induced by Re-irradiation in Brain Tumor Patients

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iNOS在血管再狭窄大鼠的表达及黄芪当归的作用

目的:观察iNOS在血管再狭窄大鼠的表达变化及黄芪、当归的作用。方法:建立内皮剥脱后血管再狭窄动物模型,随机分为对照组、模型组、黄芪治疗组、当归治疗组、黄芪当归联合治疗组;治疗组在造模后给药,连续给药21 d,应用组织形态学、免疫组化的方法分别检测观察术后3,7,14,21 d iNOS在增生内膜中表达变化,并观察中药黄芪、当归注射液单独及联合应用对iNOS表达的影响。结果:正常主动脉内膜和中膜均检测到极少量iNOS表达;术后3 d大鼠主动脉壁内膜iNOS表达增强;7～21 d随着损伤时间延长及内膜的逐渐增厚,增生内膜iNOS阳性颗粒的数量增多,颜色变深,21 d达峰值;与模型组比较,黄芪、当归治疗21 d后,iNOS棕色颗粒明显减少,颜色变浅,以联合应用组作用更为明显。结论:iNOS表达参与内皮损伤后血管再狭窄过程,黄芪、当归可抑制血管内膜损伤后引起的血管内膜增生,其机制可能与抑制iNOS表达有关。     

Longitudinal associations between metabolic score for visceral fat and hyperuricemia in non-obese adults

Background and aimsThe assessment of visceral adiposity is of great significance for the prevention of hyperuricemia (HUA), especially in non-obese individuals. The metabolic score for visceral fat (METS-VF) is a newly proposed surrogate of visceral obesity. We aimed to evaluate the longitudinal associations of METS-VF with the risk of HUA in non-obese adults.Methods and resultsA total of 16,058 non-obese adults without HUA were included for this retrospective cohort analyses. The crude incidence rate of HUA in non-obese women and men were 20.9 and 69.6 per 1000 person-years, respectively. The Cox proportional hazards model indicated that METS-VF was significantly associated with the risk of HUA in both genders. Whereas, METS-VF only had the highest HR in women, but not in men.ConclusionsMETS-VF, a novel surrogate of visceral adiposity combined biochemical and anthropometric parameters, age, and gender, could be a useful tool for the hierarchical prevention and management of HUA among non-obese women.     

Stereotactic radiofrequency ablation of tumors at the hepatic venous confluence

BackgroundRadiofrequency ablation (RFA) is subject to “heat-sink” effects, particularly for treatment of tumors adjacent to major vessels.MethodsIn this retrospective study, 104 patients with 137 tumors (40 HCC, 10 ICC and 54 metastatic liver tumors) close to (≤1 cm from) the hepatic venous confluence underwent stereotactic RFA (SRFA) between June 2003 and June 2018. Median tumor size was 3.7 cm (1.4–8.5) for HCC, 6.4 cm (0.5–11) for ICC and 3.8 cm (0.5–13) for metastases. Endpoints comprised safety, local tumor control, overall and disease-free survival.ResultsThe overall major complication rate was 16.0% (20/125 ablations), where 8 (40%) were successfully treated by the interventional radiologist in the same anesthetic session and did not prolong hospital stay. 134/137 (97.8%) tumors were successfully ablated at initial SRFA. Local recurrence (LR) developed in 19/137 tumors (13.9%). The median and overall survival (OS) rates at 1-, 3-, and 5- years from the date of the first SRFA were 51.5 months, 73.5%, 67.0%, and 49.7% for HCC, 14.6 months, 60.0%, 32.0% and 32.0% for ICC and 38.1 months, 91.4%, 56.5% and 27.9% for metastatic disease, respectively.ConclusionSRFA represents a viable alternative to hepatic resection for challenging tumors at the hepatic venous confluence.     

海南百岁老人营养状况对全因死亡影响的前瞻性队列研究

目的探讨海南百岁老人营养状况与全因死亡风险之间的关系。方法利用中国海南百岁老人队列研究2014-2021年调查数据, 本研究共纳入1 002名基线资料完整的海南百岁老人, 随访其生存与死亡结局。根据简易营养评估量表将百岁老人的营养状况分为营养良好(12～14分)、营养不良风险(8～11分)和营养不良(0～7分)3组。利用Kaplan-Meier曲线评估百岁老人的生存状况;利用Cox比例风险回归模型评估营养状况与全因死亡之间的关联。结果 2021年5月31日随访结束后, 共发现522名百岁老人死亡, 7年全因死亡率为52.10%(522/1 002)。与营养良好组相比, 营养不良导致的平均减寿为0.62年。生存分析显示, 营养不良组全因死亡率高于其他组(χ2=16.45, P<0.001)。多因素Cox比例风险回归分析结果显示, 与营养良好的百岁老人相比, 营养不良组全因死亡风险更高(HR=1.65, 95%CI:1.18～2.31)。亚组分析发现女性百岁老人该关联更为显著。结论营养不良与海南百岁老人高全因死亡风险相关, 提示应及时评估和关注百岁老人特别是女性老人营养状况对其健康长...     

氨磷汀对小鼠肠型急性放射病的防护作用及其机制

 目的 研究氨磷汀(amifostine, WR2721)对小鼠肠型急性放射病的防护作用及其机制。方法 建立小鼠肠型急性放射病模型。C57BL/6J小鼠随机分为对照组和WR2721给药组,接受15 Gy ⁶⁰Co-γ全身照射,照后移植健康小鼠骨髓细胞,观察小鼠受照后30 d的存活率和平均生存时间,以及用隐窝细胞微克隆实验,研究照后3.5 d隐窝细胞数量及小肠黏膜情况。结果 对照组小鼠均在10 d内死亡,WR2721给药组存活率提高到80%;对照组和WR2721给药组平均隐窝数分别为(6.1±0.7)个、(28.0±1.1)个,差异有统计学意义(P<0.0001);对照组和WR2721给药组绒毛高度分别为(51.48±2.04)μm、(73.29±3.24)μm,差异有统计学意义(P<0.0001)。结论 WR2721对肠型急性放射病小鼠有保护作用,通过提高隐窝干细胞增殖活性,促进黏膜的恢复,提高小鼠的存活率。     

一氧化氮合酶抑制剂对脊髓损伤后运动功能的影响

目的观察诱导型和神经型一氧化氮合酶(iNOS,nNOS)抑制剂对大鼠脊髓损伤(SCI)后运动功能的影响和机理。方法大鼠脊髓压迫伤后分别给予iNOS和nNOS抑制剂—氨基胍(AG)和7-硝基吲唑(7-NI)进行治疗,24h后用分光光度法测定组织中一氧化氮(NO)含量和一氧化氮合酶(NOS)活性,72h后用流式细胞仪检测神经细胞凋亡情况,4周后用电生理和动物行为学等指标评价运动功能的恢复情况。结果AG和7-NI均可以抑制组织中的NO含量,并使NOS活性下降,同时降低神经细胞的凋亡比率,对运动功能的恢复前者优于后者。结论脊髓损伤后应用NOS抑制剂可以使伤后运动功能得到改善,AG的作用似乎更明显,提示iNOS活性变化可能对脊髓损伤的恢复更具决定作用。     

以海藻酸盐及异种骨复合技术制备组织工程化骨及体内成骨(英文)

背景:海藻酸有相对温和的凝胶条件与良好的生物相容性,已广泛应用于生物组织工程.目的:采用海藻酸钠凝胶复合异种骨的方法,构建骨组织工程载体,观察载体中细胞的生物性能及体内成骨能力.方法:取2只2周龄新西兰兔的骨髓,以1 ×10~(-8)mol/L重组人骨形态发生蛋白2诱导骨髓间充质干细胞.取诱导后第2代骨髓间充质干细胞接种于1%海藻酸钠凝胶中,培养4 d苏木精-伊红染色观察凝胶中细胞形态.将第2代骨髓间充质干细胞分为单纯DMEM凝胶组和含1%海藻酸钠的DMEM凝胶组,分别培养7 d后行骨形态发生蛋白2免疫组织化学染色观察.取24只裸鼠,随机分为2组,于两侧股部肌袋中分别植入骨髓间充质干细胞,海藻酸钠凝胶/牛松质骨复合体作为实验组,骨髓间充质干细胞,牛松质骨复合体作为对照组.术后2,4周后组织学观察复合体成骨情况,图像分析系统分析各组成骨或软骨的面积百分比.结果与结论:海藻酸钠凝胶中骨髓间充质干细胞形态饱满,细胞悬浮于凝胶中,可见细胞分裂和核分裂相.单纯DMEM凝胶组和含1%海藻酸钠的DMEM凝胶组免疫组织化学观察,细胞分裂增殖正常,伸出多种形态的突起,胞核大,核仁清晰.单纯DMEM凝胶组和含1%海藻酸钠的DMEM凝胶组的骨形态发生蛋白2表达阳性率差异无显著性意义(P>0.05).扫描电镜观察海藻酸钠凝胶均匀地复合于牛松质骨微孔中,不同平面均有细胞生长.动物实验显示术后2,4周实验组和对照组的成骨或软骨的面积百分比差异有显著性意义(P<0.05).提示以海藻酸钠凝胶,牛松质骨构建骨组织工程载体,合乎组织工程载体的超结构原理,能最大限度地承载细胞,生物性能好,对骨髓间充质干细胞增殖和成骨表型及相关的生物性能无不良影响,在体内成骨效率较高.