PCS法与常规介入法治疗中晚期肝癌疗效的对比分析

目的:评价PCS法与常规介入法治疗中晚期肝癌的疗效对比,以利选择合理的治疗方法。材料和方法:自1994年1月～1996年5月间行常规法治疗150例和PCS法治疗57例中晚期肝癌患者,以生存率、肿块缩小率及并发症发生率,综合分析二种方法的疗效。结果:1年存活率常规法与PCS法无差异,2疗程后肿瘤最大径缩小>1/3者常规法优于PCS法,并发症发生率PCS组高于常规组。结论:对于中晚期癌症患者,首选常规介入法;身体状况较差者,以PCS法为优。     

Impact of Short-Term Complications on Mortality and Quality of Life After Transcatheter Aortic Valve Replacement

Objectives

The aim of this study was to examine the independent association of short-term complications of transcatheter aortic valve replacement (TAVR) with survival and quality of life at 1 year.

Health Conditions: Effect on Function,Health-Related Quality of Life,and Life Satisfaction After Traumatic Spinal Cord Injury. A Prospective Observational Registry Cohort Study

Objective

To analyze relations among injury, demographic, and environmental factors on function, health-related quality of life (HRQoL), and life satisfaction in individuals with traumatic spinal cord injury (SCI).

Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial

Objective

To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP).

Supersaturated polymeric micelles for oral cyclosporine A delivery

Polymeric micelles provide a promising platform for improving oral absorption of poorly soluble drugs. However, improved understanding of how drug retention within the hydrophobic micelle core can reduce drug absorption is required. We designed supersaturated polymeric micelles (Super-PMs) to increase molecularly dissolved drug concentration and gain an insight into the effect of the degree of supersaturation on oral absorption of cyclosporine A (CsA) in rats. The drug release from Super-PMs increased with an increase in initial supersaturation degrees in micelles. The cellular uptake of coumarin-6 was reduced by the retention of drug in polymer micelles. The transport flux of CsA across Caco-2 monolayer was increased with initial supersaturation degrees of 0.81–3.53 (p < 0.05). However, increase in supersaturation to 5.64 actually resulted in decreased CsA transport. The same trend was observed in a rat in vivo absorption study, in which the highest bioavailability of 134.6 ± 24.7% (relative to a commercial product, Sandimmun Neoral®, p < 0.01) was achieved when the supersaturation degree was 3.53. These results demonstrated that Super-PMs were a promising drug delivery system for compounds with low aqueous solubility. This study also provided an experimental proof for the hypothesis that moderately supersaturated formulations are valuable alternative to high supersaturation formulations, resulting in optimal in vivo performance, and the degree of supersaturation should be carefully controlled to optimize drug absorption.     

Vascular calcification: the price to pay for anticoagulation therapy with vitamin K-antagonists

Vitamin K-antagonists (VKA) are the most widely used anti-thrombotic drugs with substantial efficacy in reducing risk of arterial and venous thrombosis. Several lines of evidence indicate, however, that VKA inhibit not only post-translational activation of vitamin K-dependent coagulation factors but also synthesis of functional extra-hepatic vitamin K-dependent proteins thereby eliciting undesired side-effects. Vascular calcification is one of the recently revealed side-effects of VKA. Vascular calcification is an actively regulated process involving vascular cells and a number of vitamin K-dependent proteins. Mechanistic understanding of vascular calcification is essential to improve VKA-based treatments of both thrombotic disorders and atherosclerosis. This review addresses vitamin K-cycle and vitamin K-dependent processes of vascular calcification that are affected by VKA. We conclude that there is a growing need for better understanding of the effects of anticoagulants on vascular calcification and atherosclerosis.     

Effect of patient-controlled sedation with propofol on patient satisfaction: A randomized study

Background

In this trial we sought to determine whether propofol-based patient-controlled sedation (PCS) during diagnostic cerebral angiography would result in improved patient satisfaction compared to placebo-based PCS.

Methods

We randomly assigned 61 patients to receive propofol-based PCS (n = 33, 15 mg bolus in 9 s) or placebo-based PCS (n = 28, bolus of 1.5 mL of a 20% lipid emulsion in 9 s). We recorded the number of PCS bolus requirements, the need for rescue sedative drugs, and physiological variables. Prior to the procedure, the anxiety level of each patient was evaluated using the Anxiety State Traits Assessment (STAI) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The quality of patient conditioning was quoted by both the anesthetist and neuroradiologist using Visual Analog Scale (VAS). The day following the procedure, patients were given the EVAN questionnaire, a validated tool for assessing patient satisfaction.

Results

Both groups were similar in term of demographics, American Society of Anesthesiologist (ASA) physical status scores, STAI and APAIS scores, and procedure lengths. There were no differences between groups in EVAN scores 76.9 ± 16.1 vs. 75.7 ± 12.8; P = 0.78. The number of PCS bolus requirements was significantly higher in the placebo group 3.96 ± 9.5 vs. 3.13 ± 3.1 (P = 0.02). No adverse event was recorded.

Conclusion

This prospective, double-blind, randomized study showed that sedation using propofol PCS did not improve patients’ satisfaction during diagnostic cerebral angiography. Therefore, an anesthetist should be rapidly available on request but not necessarily present during the whole procedure.