Qianzheng powder for the treatment of primary Hemifacial spasm: A protocol for systematic reviews and meta-analysis

Background:Hemifacial spasm (HFS) is a clinical common neurological disease, its main performance for 1 side or 2 sides muscles (the orbicularis oculi muscle, expression, orbicularisoris muscles) recurrent paroxysmal, involuntary twitching, aggravating when excited or nervous, more severe cases of the disease may include difficulty in opening the eyes, crooked corners of the mouth, and twitching noises in the ears, etc.^[1] Early manifestations of the disease are intermittent mild convulsions of the orbicularis oculi muscle, and then gradually spread to 1 side of the facial muscles, such as frowning muscles, nasal muscles, buccinalis muscles, etc, especially the most obvious spasms of the oral muscles, which can involve the ipsilateral platysma muscle in severe cases, with each twitch for a few seconds to a few minutes. The disease will affect the quality of life such as speaking, eating, seeing and so on, and even cause psychological effects such as inferiority, anxiety and depression. At present, the incidence of the disease in China is 11 per 1.1 million, females are more common than males. There are many ways to treat HFS, but the Qianzheng powder has a unique advantage in treating this disease. Therefore, our systematic review aims to evaluate the efficacy and safety of Qianzheng powder in the treatment of Primary Hemifacial spasm, and to provide a reliable basis for clinical decision makers.Methods:From its inception until April 2021, we will search electronic databases, including PubMed, Embase, Cochrane Library, China Biomedical Literature Database, China Knowledge Infrastructure, Wanfang Database, and China Scientific Journals Database. The authors will independently sift through studies, extract data information, and assess methodological quality using the Cochrane Risk of Bias tool. The RevManV. 5.3 software will be used for statistical analysis.Results:The results of this study, which will be published in a peerreviewed journal, will evaluate the efficacy and safety of Qianzheng powder in the treatment of primary Hemifacial spasm.Conclusion:This systematic review will provide reliable evidence-based basis for treating primary Hemifacial spasm with Qianzheng powder.INPLASY Registration number:INPLASY202130037.     

外伤性血尿患者膀胱痉挛的护理干预

目的探讨护理干预对降低外伤性血尿患者膀胱痉挛发生率的作用.方法回顾性分析昆明市延安医院2010年4月至2012年9月之间不同方式护理干预处理的外伤性血尿147例患者的护理经验.结果改进护理措施处理78例患者中有18例发生过膀胱痉挛,发生率为23%;采用常规护理措施的69例患者中计有27例发生过膀胱痉挛,发生率为39%.两者相比差异有统计学意义(P<0.05).结论改进护理干预可有效降低外伤性血尿患者膀胱痉挛的发生率.     

A Phase II Study of Biodegradable Stents Plus Palliative Radiotherapy in Oesophageal Cancer

AimsSelf-expanding metal stents provide rapid improvement of dysphagia in oesophageal cancer but are associated with complications. The aim of the present study was to test the effectiveness of an alternative treatment of combining biodegradable stents with radiotherapy.Materials and methodsA Simon two-stage single-arm prospective phase II trial design was used to determine the efficacy of biodegradable stents plus radiotherapy in patients with dysphagia caused by oesophagus cancer who were unsuitable for radical treatment. Fourteen patients were recruited and data from 12 were included in the final analyses.ResultsFive of 12 patients met the primary end point: one stent-related patient death; four further interventions for dysphagia within 16 weeks of stenting (41.7%, 95% confidence interval 15.2–72.3%). The median time to a 10-point deterioration of quality of life was 2.7 weeks. Nine patients died within 52 weeks of registration. The median time to death from any cause was 15.0 weeks (95% confidence interval 9.6–not reached).ConclusionThe high re-intervention observed, which met the pre-defined early stopping criteria, meant that the suggested alternative treatment was not sufficiently effective to be considered for a larger scale trial design. Further work is needed to define the place of biodegradable stents in the management of malignant oesophageal strictures.     

Terlipressin (Triglycyl-Lysine Vasopressin) Controls Acute Bleeding Oesophageal Varices: A Double-Blind,Randomized, Placebo-Controlled Trial

The haemostatic effect of terlipressin (triglycyl-lysine vasopressin; Glypressin^®) on bleeding from oesophageal varices was evaluated in a placebo-controlled, double-blind, randomized clinical trial. Patients with clinically suspected liver cirrhosis were included in the study if they had been admitted to hospital with an extensive haemorrhage within the last 24 h before diagnostic endoscopy. The patients randomized after stratification for severity of liver disease. Terlipressin or placebo was administered as intravenous bolus injections every 4th h during a period of 24 to 36 h or until the clinical course necessitated active intervention (failure or withdrawal). Sixty patients entered the study; 31 patients were allocated to receive terlipressin, and 29 patients to receive placebo. Bleeding from varices was arrested in 28 of the 31 receiving terlipressin, as compared with 17 of the 29 receiving placebo (p < 0.01). Patients receiving active drug required significantly fewer blood transfusions (p < 0.05). Most of the side effects were classified as mild and were registered in the terlipressin group.     

Replacement of tenofovir with adefovir may result in reactivation of hepatitis B virus replication

Ten investigations of acid reflux by means of 12-hour continuous pH monitoring at the distal end of the oesophagus, and 10 acid-clearing tests were performed within 6 weeks on the same volunteer with the purpose of examining the reproducibility of the results of these tests. Intragastric pH was studied over 12 hours and proved to be under 3 during the whole period of investigation. For the acid reflux test the coefficient of variation was 0.61-0.94, depending on the criteria for reflux. For the acid-clearing test the coefficient of variation was 0.22. For both tests the results of the separate investigations varied within normal ranges.     

经尿道前列腺切除术后膀胱痉挛相关因素分析及临床治疗

目的探讨经尿道前列腺切除术后膀胱痉挛相关致病因素与临床治疗方法。方法回顾性分析我院2008年8月-2010年6月行经尿道前列腺切除术患者临床资料。结果101例患者中发生膀胱痉挛49例，发生率为48．5％；对照组和实验组患者治疗有效率分别为80％和100％，实验组治疗有效率明显高于对照组，组间比较差异有统计学意义（P〈0．05）。结论经尿道前列腺切除术术后膀胱痉挛与膀胱内环境不稳定、术后出血、精神因素有关；通过综合治疗能够有效控制症状，减轻患者痛苦，减少并发症，具有临床推广使用价值。     

Oesophageal echocardiography

Summary The diagnostic value of oesophageal echocardiography is most striking in patients in whom precordial studies are of inadequate quality or fail to establish a definitive diagnosis. Oesophageal studies have excellent image quality, can be completed within 10 minutes without complications and, in most instances, enables the clinical question to be answered. In 50 patients referred for suspected thoracic aorta pathology, oesophageal echocardiography correctly excluded or diagnosed the type of aortic dissection, aortic aneurysm or the site of coarctation. Of 35 patients referred with suspected infective endocarditis, oesophageal echocardiography revealed complications in 18 patients, including vegetation, mycotic aneurysm, abscess or chordal rupture. Oesophageal echocardiography is extremely helpful to visualize intracardiac mass lesions. In 27 patients with a history of systemic or pulmonary embolism, the technique confirmed the presence, size and position of a mass lesion in 11 patients. Oesophageal color Doppler flow imaging further expands the diagnostic capabilities, particularly in patients with mitral valve prosthesis. Our experience indicates that oesophageal echocardiography significantly extends the diagnostic potential of echocardiography. Detailed knowledge of cardiothoracic anatomy and its pathologic sequelae is, however, a prerequisite for the efficient and safe application of this method.     

Endoscopy in Barrett's oesophagus: adherence to standards and neoplasia detection in the community practice versus hospital setting

Objective. Potential process differences between hospital and community‐based endoscopy for Barrett’s oesophagus have not been examined. We aimed at comparing adherence to guidelines and neoplasia detection rates in medical centres (MC) and community practices (CP). Design. Retrospective analysis. Setting. All histologically confirmed Barrett cases seen over a 3‐year period in six MC and 19 CP covering a third of all upper gastrointestinal endoscopies (n = 126 000) performed annually in Berlin, Germany. Main outcome measure. Rate of relevant neoplasia (high‐grade intraepithelial neoplasia or more) in both settings in relation to adherence to standards. Results. Of 1317 Barrett cases, 66% were seen in CP. CP patients had a shorter mean Barrett length (2.6 cm vs. 3.8 cm; P < 0.001) with fewer biopsies taken during an examination (2.5 vs. 4.1 for Barrett length ≤2 cm; P < 0.001). CPs also provided fewer complete esophagogastroduodenoscopy documentation (25.1% vs. 57.8%, P < 0.001). Neoplasias were found more commonly in MCs compared to CPs (9.2% vs. 0.8%; P < 0.001). However, on exclusion of all referred patients with known neoplasia (65%) or those examined for other reasons (27.5%), the detection rate at MCs decreased to 1.3%, not different from the one seen at CPs (0.8%, P = 0.43). Only 13% were found during surveillance, but 57% were diagnosed at an early stage. Conclusions. Referral bias and not better adherence to guidelines could explain the higher neoplasia prevalence in Barrett’s oesophagus at hospital centres. Despite a generally poor adherence to guidelines, most neoplasias found were at an early and potentially curable stage.