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Objetivo: Analisar as evidências sobre o efeito dos agentes tópicos empregados para a prevenção da radiodermatite em pacientes com câncer. Método: Revisão sistemática de estudos clínicos randomizados duplos-cegos construída conforme recomendações do Joanna Briggs Institute e busca nas bases de dados MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase, Scopus, além da literatura cinzenta. Utilizaram-se a ferramenta de avaliação crítica do JBI para ensaios clínicos randomizados para avaliar a possibilidade de viés, o Grading of Recommendations, Assessment, Development and Evaluation para a qualidade das evidências e o Gradepro® para recomendá-las. Resultados: Selecionaram-se 13 estudos que avaliaram diferentes agentes tópicos para prevenir a radiodermatite, a saber: corticosteroides, de ação antioxidante e fitoterápicos. A qualidade metodológica de cada estudo foi apropriada, mas a qualidade da evidência gerada pela reunião deles foi baixa, independentemente do tipo de agente tópico empregado, sugerindo que a confiança no seu efeito é limitada e tornando a força de recomendação fraca. Conclusão: Alguns agentes tópicos mostraram-se promissores para a prevenção de radiodermatite, mas as evidências aqui reunidas sobre a eficácia deles não permitem indicar seu uso para a prevenção de radiodermatite em pacientes com câncer. (AU)
Objective: To analyze the evidence on the effect of topical agents to prevent radiodermatitis in cancer patients. Methods: Systematic review of double-blind randomized clinical studies built according to JBI recommendations and search in the databases MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase and Scopus, in addition to the Gray Literature. The JBI critical assessment tool for randomized clinical trials was used to assess the possibility of bias, GRADE for the quality of evidence, and Gradepro® to recommend them. Results: Thirteen studies were selected that evaluated different topical agents to prevent radiodermatitis, namely: corticosteroids, with antioxidant action and herbal medicines. The methodological quality of each study was appropriate. Still, the quality of evidence generated by pooling them was low, regardless of the type of topical agent employed, suggesting that confidence in its effect is limited and weakening the strength of the recommendation. Conclusions: Some topical agents have shown promise for the prevention of radiodermatitis, but the evidence gathered here about their effectiveness does not indicate their use for the prevention of radiodermatitis in cancer patients. (AU)
Objetivo: Analizar la evidencia sobre el efecto de los agentes tópicos utilizados para la prevención de la radiodermatitis en pacientes con cáncer. Método: Revisión sistemática de estudios clínicos aleatorizados, doble ciego, elaborados según las recomendaciones del JBI y buscados en MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase y Scopus, además de literatura gris. Se utilizó la herramienta de evaluación crítica JBI para ensayos clínicos aleatorios para evaluar la posibilidad de sesgo, GRADE para la calidad de la evidencia y Gradepro® para recomendarla. Resultados: Se seleccionaron trece estudios que evaluaron diferentes agentes tópicos para prevenir la radiodermatitis, a saber: corticosteroides, con acción antioxidante y fitoterapia. La calidad metodológica de cada estudio fue apropiada, pero la calidad de la evidencia generada al combinarlos fue baja, independientemente del tipo de agente tópico empleado, lo que sugiere que la confianza en su efecto es limitada y debilita la fuerza de la recomendación. Conclusión: Algunos agentes tópicos se han mostrado prometedores para la prevención de la radiodermatitis, pero la evidencia aquí reunida sobre su eficacia no nos permite indicar su uso para la prevención de la radiodermatitis en pacientes con cáncer. (AU)
Subject(s)
Humans , Male , Female , Radiodermatitis/prevention & control , Radiotherapy , Enterostomal TherapyABSTRACT
Objective:To explore the effect of Quercus Salicina Extract Capsulese on preventing the formation of adherent stones on ureteral stent tube after percutaneous nephrolithotomy (PCNL).Methods:The clinical data of 186 patients who underwent PCNL due to unilateral renal stone in the Affiliated Hospital of Xuzhou Medical University from October 2018 to April 2020 were retrospectively analyzed. All of the patients were indwelling 6 F ureteral stent tube during operation. After postoperative reexamination of kidneys, ureters and bladder, it was confirmed that the postoperative residual stones were clinically meaningless stones (maximum diameter ≤ 4 mm). According to postoperative medication, they were divided into drug group ( n=62) and control group ( n=124). Patients in the drug group were given oral Quercus Salicina Extract Capsules, while patients in the control group did not take the drug. Both groups received the same health education and dietary guidance after operation. The formation of adherent stones on ureteral stent tube was observed when the ureteral stent tube was removed 6 weeks after PCNL. Meanwhile, the adverse reaction, complication and treatment satisfaction of the patients were recorded during the period of taking the drug. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; the Chi-square test was used to compare the count data between groups. Results:When the ureteral stent tube was removed 6 weeks after PCNL, the weight of adherent stones on ureteral stent tube in the drug group was (334.20±26.65) mg for male, and (336.00±25.64) mg for female. In the control group, the weight of adherent stones on ureteral stent tube was (374.11±42.28) mg for male, (374.42±42.44) mg for female. The weight of adherent stones on ureteral stent tube in the drug group was significantly lighter than that in the control group, and the difference was statistically significant ( P<0.01). The drug group had no obvious serious adverse reaction during the period of taking the drug. At the same time, the complications of the drug group during the intubation period were significantly less than the control group, and the difference was statistically significant ( P=0.040). The satisfaction of patients in the drug group was 93.5%, and that in the control group was 82.3%. The difference was statistically significant between the two groups ( P=0.036). Conclusion:Quercus Salicina Extract Capsules can effectively prevent the occurrence of adherent stones on ureteral stent tube after PCNL, and there are no serious adverse reaction, which is worthy of clinical promotion.
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Purpose: To explore the protection of naringenin against oxygen-glucose deprivation/reperfusion (OGD/R)-induced HT22 cell injury, a cell model of cerebral ischemia/reperfusion (I/R) injury in vitro, focusing on SIRT1/FOXO1 signaling pathway. Methods: Cytotoxicity, apoptosis, reactive oxygen species (ROS) generation, malondialdehyde (MDA) content, 4-hydroxynonenoic acid (4-HNE) level, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) activities were measured by commercial kits. Inflammatory cytokines levels were determined by enzyme-linked immunosorbent assay (ELISA). The protein expressions were monitored by Western blot analysis. Results: Naringenin significantly ameliorated OGD/Rinduced cytotoxicity and apoptosis in HT22 cells. Meanwhile, naringenin promoted SIRT1 and FOXO1 protein expressions in OGD/R-subjected HT22 cells. In addition, naringenin attenuated OGD/R-induced cytotoxicity, apoptosis, oxidative stress (the increased ROS, MDA and 4-HNE levels, and the decreased SOD, GSH-Px and CAT activities) and inflammatory response (the increased tumor necrosis factor-α, interleukin [IL]-1ß, and IL-6 levels and the decreased IL-10 level), which were blocked by the inhibition of the SIRT1/FOXO1 signaling pathway induced by SIRT1-siRNA transfection. Conclusion: Naringenin protected HT22 cells against OGD/R injury depending on its antioxidant and anti-inflammatory activities via promoting the SIRT1/FOXO1 signaling pathway.
Subject(s)
Reperfusion Injury , Signal Transduction , Oxidative Stress , Inflammation Mediators , Flavanones/administration & dosageABSTRACT
Irradiation injuries anti-agents refer to drugs that can inhibit the initial stage of radiation injuries, or reduce the development of radiation injuries and promote the recovery of injuries when used early after irradiation exposure. According to the mechanism of action and the time of intervention, the irradiation injuries anti-agents are divided into four categories: radioprotectors, radiomitigators, radiation therapeutics for external radiation exposure, and anti-agents for internalized radionuclides. In this paper, the research progress of irradiation injuries anti-agents in recent years is reviewed.
Subject(s)
Humans , Radiation-Protective Agents/therapeutic use , Radiation Injuries/prevention & controlABSTRACT
RESUMEN Objetivo. Demostrar cual es el resultado de la protección del aceite de Sacha inchi (SI) al realizar una inducción artificial de artritis al inyectar carragenina a ratas Holtzman. Métodos. Estudio cuantitativo, experimental y correlacional; se usaron 30 ratas macho: divididos en cinco grupos aleatorios : 1) Solución salina fisiológica (SSF) 2 mL/kg; 2) Carragenina (C) 0,1 mL solución 2% vía intraarticular, en la zona de la articulación del fémur con la tibia izquierda; 3) C y SI 250 mg/kg; 4) C y SI 1125 mg/kg; y 5) C y SI 2250 mg/ kg; determinándose tiempo (segundos), tipo de prensión (normal, pobre, regular, moderada, intensa), e inflamación pannus, fibrosis pannus, mediante estudio histopatológico. Se aplicó análisis de varianza, y los test de Tukey y Fisher. Resultados. Hubo mayor porcentaje de efecto antiinflamatorio dosis dependiente y tiempo de prensión a 2250 mg/Kg, seguido por 1125 mg/Kg. El estudio histopatológico mostró un pannus leve y fibrosis ausente con la dosis más alta; a dosis de 1125 mg/Kg de aceite SI hubo pannus moderado, y fibrosis leve. Conclusiones. Se demostró el resultado protector del aceite de Sacha Inchi (SI) aumentando y mejorando el tiempo tipo de prensión y reducción del pannus en la artritis inducida por carragenina en ratas Holtzman.
ABSTRACT Objective. To demonstrate the protective effect of Sacha inchi oil (SI) in arthritis induced by carrageenan in Holtzman rats. Methods. Quantitative, experimental and correlational study; 30 rats, males, randomly distributed in 5 groups were used: 1) SSF 2 mL/kg; 2) Carrageenan; 3) 4) and 5) Sacha inchi. Except for the control, they received 0.1 mL 2% carrageenan intra-articularly (the area of the femur joint with the left tibia); sacha inchi oil orally 225, 1125 and 2250 mg/kg correspondingly; determining time (seconds), type of grip (normal, poor, regular, moderate, intense), and pannus inflammation, pannus fibrosis by means of histopathological study. Applying analysis of variance, Tukey and Fisher test. Results. There was a higher percentage of dose-dependent anti-inflammatory effect and grasp time at 2250 mg/Kg, followed by 1125 mg/Kg; and the histopathological study showed mild pannus and absent fibrosis with the highest dose, in contrast to doses of 1125 mg/Kg of oil there was moderate pannus, and mild fibrosis. Conclusions. The protective effect of Sacha inchi oil (SI) has demonstrated by increasing the time and improving the type of grasp and reducing the pannus in arthritis induced by carrageenan in Holtzman rats.
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The gastrointestinal mucosa covers the entire gastrointestinal tract. With important physiological functions, the injuries of mucosal barrier are the common pathogenic mechanism of gastrointestinal diseases. However, there still lacks in-depth and systematic understanding in the clinical diagnosis, etiological diagnosis, treatment strategies of mucosal barrier injuries, and the standardized use of mucosal protective agents. Based on medicine-based evidence, this consensus has reached an agreement on the concept of gastric mucosal barrier and protection, physiological functions of mucosal barrier, gastrointestinal mucosal injuries and related diseases, and the classification and application of mucosal protective agents. The consensus provides a significant reference for gastrointestinal mucosal protection in clinical practice.
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Purpose: To evaluate the protective effect of Cuscuta chinensis Lam. polysaccharides (PCCL) on 5-fluorouracil-(5-FU)-induced intestinal mucositis (IM) in mice. Methods: PCCL was orally administered at a dose of 20 mg·kg1 for 7 days and its protective effect on 5-FU-induced IM (5-FU, 50 mg·kg1 for 5 days) was evaluated by monitoring changes in body weight, degree of diarrhea, levels of tissue inflammatory factors (tumor necrosis factor α, interleukin 6, and interleukin 1ß levels), apoptosis rates, and the expression levels of caspase-3, Bax and Bcl-2. Results: The severity of mucosal injury (as reflected by body weight changes, degree of diarrhea, height of villi, and damage to crypts) was significantly attenuated by PCCL administration. PCCL also reduced the levels of tissue inflammatory factors, the apoptosis rate, and the expression of caspase-3 and Bax, and increased Bcl-2 expression. Conclusions: PCCL administration may be significantly protective against 5-FU-induced IM by inhibiting apoptosis and regulating the abnormal inflammation associated with it.
Subject(s)
Animals , Mice , Polysaccharides/therapeutic use , Cuscuta/chemistry , Mucositis/drug therapy , Fluorouracil/adverse effects , Protective Agents/analysisABSTRACT
Pancreatic fistula is a common complication after distal pancreatectomy, and its occurrence will increase the risk of other postoperative complications and even lead to the death of patients. Although the grading diagnosis of postoperative pancreatic fistula has been widely applied, the diagnosis of grade B pancreatic fistula is relatively broad. Further stratification is needed to assist in the disease severity assessment and treatment of postoperative patients. In terms of the prevention of pancreatic fistula after distal pancreatectomy, there are still controversies in the aspects of intraoperative operation, early postoperative nutritional support, the timing of drainage tube removal, and the use of somatostatin analogs. Therefore, this article will discuss many problems including grading and prevention of pancreatic fistula after distal pancreatectomy, to provide a more persuasive clinical basis.
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Objective:To investigate the preventive effects of hydroxyethyl starch and methoxamine on complications of combined spinal and epidural anesthesia in older adult patients and its influence on hemodynamics.Methods:The clinical data of 120 older adult patients who underwent combined spinal and epidural anesthesia in General Hospital of Armed Police and Marine Police between February 2017 and April 2019 were retrospectively analyzed. The included patients were divided into two groups according to the adverse reactions of drugs used to induce anesthesia: control group (methoxamine injection, n = 55) and observation group (methoxamine + hydroxyethyl starch, n = 65). The changes in hemodynamic index, complications and cognitive function were analyzed in each group. Results:Systolic blood pressures measured at 5, 15 and 30 minutes after anesthesia were (127.53 ± 10.63) mmHg, (119.85 ± 10.86) mmHg, (125.45 ± 10.74) mmHg, respectively in the observation group, which were significantly higher than (118.23 ± 11.32) mmHg, (114.34 ± 10.32) mmHg, (119.01 ± 10.34) mmHg in the control group ( t = 3.66, 2.24, 2.63, all P < 0.05). Diastolic blood pressures measured at 5, 15 and 30 minutes after anesthesia were (76.65 ± 9.07) mmHg, (78.43 ± 9.32) mmHg, (80.19 ± 9.43) mmHg, respectively in the observation group, which were significantly higher than (63.30 ± 9.43) mmHg, (65.98 ± 9.26) mmHg, (70.38 ± 9.17) mmHg in the control group ( t = 6.24, 5.78, 4.55, all P < 0.05). Heart rates measured at 5, 15 and 30 minutes after anesthesia were (73.65 ± 7.67) beats/min, (83.27 ± 9.57) beats/min, (84.10 ± 9.67) beats/min respectively in the observation group, which were significantly higher than (69.76 ± 7.82) beats/min, (64.70 ± 9.38) beats/min, (65.80 ± 9.43) beats/min in the control group ( t = 2.17, 8.46, 8.27, all P < 0.05). The incidences of hypotension and bradycardia in the observation group were 3.08% (2/65) and 3.08% (2/65), respectively, which were significantly lower than 25.45% (14/55) and 21.82% (12/55) in the control group ( χ2 = 12.91, 10.15, both P < 0.05). The Mini Mental State Examination scores measured at 1, 6 and 24 hours after surgery were (26.69 ± 2.51) points, (26.74 ± 2.75) points, and (26.99 ± 2.36) points, respectively in the observation group, which were significantly higher than (23.17 ± 2.41) points, (23.43 ± 2.36) points, and (24.18 ± 2.12) points in the control group ( t = 6.17, 5.55, 5.39, all P < 0.05). Conclusion:Hydroxyethyl starch combined with methoxamine for combined spinal and epidural anesthesia in older adult patients can effectively reduce the hemodynamic fluctuations, decrease the incidences of hypotension and bradycardia, and does not produce a remarkable effect on postoperative cognitive function.
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Objective:To investigate the clinical efficacy of low-dose aspirin in the prevention of preeclampsia recurrence during pregnancy.Methods:Thirty-six women in the first trimester of pregnancy who received examination in Hangzhou Women's Hospital from January 2018 to June 2019 were included in this study. All included women had a history of preeclampsia or severe preeclampsia and met the indications of oral aspirin. They were randomly divided into A ( n = 14) and B ( n = 22) groups. An additional 51 pregnant women who had no history of preeclampsia or severe preeclampsia were included in the control group. The A group was given oral aspirin 50-100 mg/d starting from the second trimester of pregnancy. The other two groups were not given oral aspirin at the same time. Pregnancy outcomes (including delivery weeks, cesarean delivery, placental abruption, preeclampsia, postpartum hemorrhage and gestational hypertension) and urine protein were compared between groups. Neonatal outcomes in different groups were analyzed. Results:The incidence of eclampsia in B group was [40.91% (9/22)], which was significantly higher than [7.14% (1/14)] in A group and [0.00% (0/51)] in control group ( χ2 = 9.872, 12.031, both P < 0.05). The cesarean delivery rate in B group was [22.73% (5/22)], which was significantly higher than 7.14% (1/14) in A group and 5.88% (3/51) in control group ( χ2 = 8.072, 10.810, both P < 0.05). Delivery weeks in A and control groups were (42.78 ± 1.32) weeks and (43.14 ± 1.17) weeks, respectively, which were significantly longer than (35.08 ± 2.03) weeks in group B ( F = 13.765, P < 0.05). The amount of blood loss in A and control groups was (217.62 ± 19.85) mL and (211.37 ± 18.56) mL, respectively, which was significantly less than (233.05 ± 22.37) mL in B group ( F = 18.873, P < 0.05). The Apgar score of newborns in B group was (6.03 ± 0.54) points, which was significantly lower than (9.58 ± 0.86) points in A group and (9.73 ± 0.85) points in control group ( F = 9.037, P < 0.05). The incidence of intrauterine growth restriction [7.14% (1/14), 5.88% (3/51)] and the incidence of preterm birth [7.14% (1/14), 5.88% (3/51)] in A and control groups were significantly lower than those in B group [22.73% (1/22), 15.00% (3/22), χ2 = 10.651, 14.040, 11.715, 13.602, all P < 0.05]. There were no significant differences in the incidence of neonatal death and hemorrhagic diseases among the three groups ( χ2 = 2.020, 3.606, both P > 0.05). Conclusion:Aspirin enteric coated tablets 50-100 mg/d per day for management of pregnant women at a high risk for preeclampsia at 12 weeks of gestation can decrease the incidence of preeclampsia to a certain extent, which is worthy of clinical application.
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At present, there is no effective treatment method of radiation-induced intestinal injury. Clinically, only symptomatic remission therapy can be used. Intestinal stem cells (ISCs) have strong renewal ability, which is an important part of intestinal structure regeneration. To promote the recovery of the number and function of ISCs has been a research hotspot in the treatment of radiation gastrointestinal syndrome. This article introduces the important role of ISCs in the protection of radiation-induced intestinal injury and its clinical application significance from the classification and regulatory mechanism of ISCs, and drugs that regulate the damage, apoptosis and repair of stem cells, so as to provide reference for the future research on the role of intestinal stem cells in radiation protection.
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Introduction: There is a high prevalence of enamel caries around brackets due to the young age of the majority of orthodontic patients, and to the difficulty of plaque removal in presence of orthodontic appliances. Recently, protective agents such as bioactive glasses (BGs) were introduced to enhance remineralization and prevent demineralization of tooth structures. This study aimed to assess the shear bond strength (SBS) of resin-modified glass ionomer cement (RMGIC) with addition of 45S5 BG to enhance its remineralizing potential using two conventional methods. Material and methods: This in-vitro experimental study evaluated three groups (n=20) of orthodontic brackets bonded to enamel using Transbond XT (group 1), light-cure RMGIC (group 2) and RMGIC with BG added (group 3). Samples underwent 7000 thermal cycles and their SBS was measured. The adhesive remnant index (ARI) score was also determined. Quantitative data were analyzed using one-way ANOVA while qualitative data were analyzed using a chi-square test. Discussion: The results showed no significant difference in SBS between study groups, however the ARI scores were significantly different among the groups. The RMGIC group showed the highest ARI while RMGIC doped with BG showed the lowest ARI score. Conclusion: Addition of 30% w/v 45S5 BG to RMGIC does not cause a significant change in SBS of orthodontic brackets bonded to enamel, while resulting in less amount of luting agent remnants on the enamel surface after debonding.
Introducción: Existe una alta prevalencia de caries del esmalte alrededor de los brackets debido a la corta edad de la mayoría de los pacientes de ortodoncia y a la dificultad de remoción de la placa en presencia de aparatos de ortodoncia. Recientemente, se introdujeron agentes protectores como los vidrios bioactivos (VB) para mejorar la remineralización y prevenir la desmineralización de las estructuras dentales. Este estudio tuvo como objetivo evaluar la resistencia al cizallamiento (RC) del cemento de ionómero de vidrio modificado con resina (CIVMR) con la adición de 45S5 BG para mejorar su potencial remineralizante utilizando dos métodos convencionales. Material y Métodos: Este estudio experimentalin vitro evaluó tres grupos (n = 20) de brackets de ortodoncia adheridos al esmalte usando Transbond XT (grupo 1), CIVMR fotopolimerizable (grupo 2) y CIVMR con VB agregado (grupo 3). Las muestras se sometieron a 7000 ciclos térmicos y se midió su RC. También se determinó la puntuación del índice de restos de adhesivo (IRA). Los datos cuantitativos se analizaron mediante ANOVA de una vía, mientras que los datos cualitativos se analizaron mediante una prueba de chi-cuadrado. Discusión: Los resultados no mostraron diferencias significativas en la RC entre los grupos de estudio, sin embargo, los puntajes IRA fueron significativamente diferentes entre los grupos. El grupo CIVMR mostró el ARI más alto mientras que CIVMR dopado con VB mostró el puntaje IRA más bajo. Conclusión: La adición de un 30% p/v de 45S5 VB a CIVMR no causa un cambio significativo en la RC de los brackets de ortodoncia adheridos al esmalte, mientras que resulta en una menor cantidad de remanentes de agente de fijación en la superficie del esmalte después del desprendimiento. Resistencia al Corte.
Subject(s)
Humans , Composite Resins , Dental Cements , Shear Strength , Orthodontic Appliances , In Vitro Techniques , Dental Bonding , Dental Caries/epidemiologyABSTRACT
Abstract The purpose of this study was to test the radioprotective effect of selenium in the bone microarchitecture of irradiated rats mandibles. Forty rats were separated into 4 groups with 10 animals: control group (CG), irradiated group (IG), sodium selenite group (SSG) and sodium selenite irradiated group (SSIG). A single dose of 0.8 mg/kg sodium selenite was administered intraperitoneally in the SSG and SSIG groups. One hour later, animals of IG and SSIG groups were irradiated with 15 Gy of x-rays. Forty days after radiation a bilateral extraction of the mandibular first molars was performed. After the extraction procedure, five rats were killed after fifteen days and others five after thirty days. Micro- computed tomography was used to evaluate cortical and trabecular bone of each rat. The mean and standard deviation of each bone microarchitecture parameter were analyzed using the statistical test of two-way Analysis of Variance (ANOVA). At 15 days, the bone volume presented higher values in the CG and SSG groups (p=0.001). The same groups presented statistically significant higher values when bone volume fraction (p<0.001) and trabecular thickness (p<0.001) were analyzed. At 30 days, it was observed that in relation to the bone volume fraction, SSG group presented the highest value while SSIG group had the lowest value, with statistically significant difference (p=0.016). Sodium selenite demonstrated a median radioprotective effect in the bone microarchitecture of irradiated mandibles, which indicates the substance may be a potential radioprotective agent against chronic effects of high doses of ionizing radiation.
Resumo O propósito deste estudo foi testar o efeito radioprotetor do selênio na microarquitetura óssea de mandíbulas de ratos irradiados. Quarenta ratos foram separados em 4 grupos com 10 animais: grupo controle (GC), grupo irradiado (GI), grupo selenito de sódio (SSG) e grupo selenito de sódio irradiado (SSIG). Uma dose única de 0,8 mg/kg de selenito de sódio foi administrada intraperitonealmente nos grupos SSG e SSIG. Uma hora depois, os animais dos grupos IG e SSIG foram irradiados com 15 Gy de raios-x. Quarenta dias após a irradiação foi realizada extração bilateral dos primeiros molares inferiores. Após o procedimento de extração, cinco ratos foram mortos após quinze dias e outros cinco após trinta dias. A microtomografia computadorizada foi utilizada para avaliar o osso cortical e trabecular de cada rato. A média e o desvio padrão de cada parâmetro da microarquitetura óssea foi analisada pelo teste estatístico de Análise de Variância dois fatores (ANOVA), seguido por comparações post hoc com o teste de Tukey. Após 15 dias, o volume ósseo apresentou valores mais elevados nos grupos GC e GNS (p=0,001). Os mesmos grupos apresentaram valores estatisticamente significantes maiores quando se analisou fração de volume ósseo (p<0,001) e espessura trabecular (p<0,001). Após 30 dias, observou-se que, em relação à fração de volume ósseo, o grupo SSG apresentou o maior valor enquanto o grupo SSIG apresentou o menor valor, com diferença estatisticamente significante (p=0,016). O selenito de sódio demonstrou um efeito radioprotetor mediano na microarquitetura óssea das mandíbulas irradiadas, o que indica que a substância pode ser um potencial agente radioprotetor contra os efeitos crônicos da radioterapia.
Subject(s)
Animals , Rats , Radiation-Protective Agents , Sodium Selenite , MandibleABSTRACT
Objective@#To explore the causes of vascular crisis caused by replantation of severed finger, and summarize the experience of prevention and treatment.@*Methods@#From April 2015 to February 2017, 108 patients with wounded finger treated in the First People's Hospital of Yongkang were divided into two groups according to the occurrence of postoperative vascular crisis situation: the control group (56 cases, vascular risk), the observation group (52 cases, vascular crisis happened). The clinical data of all patients were collected, the various data were compared, and the causes of vascular crisis were analyzed.The observation group was given low molecular dextran treatment, the changes of blood coagulation function indicators before and after treatment were observed.@*Results@#The age, disconnection plane, ischemia time had statistically significant differences between the two groups(all P<0.05). After treatment, the four coagulation function index in the observation group [fiber protease: (3.32±0.29)g/L, activated partial thrombin time: (27.56±2.08)s, thrombin time: (12.13±1.62)s, prothrombin time: (11.47±1.29)s] were improved obviously (t=4.86, 8.63, 6.04, 4.70, all P<0.05).@*Conclusion@#The age, disconnection plane and ischemic time are the factors that cause vascular crisis.In addition, postoperative pain, patients' mood, postoperative posture and other factors may also lead to vascular crisis.Preoperative assessment of the condition should be done well, postoperative monitoring should be strengthened, and prophylactic medication can be used to prevent vascular crisis.
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To explore the causes of vascular crisis caused by replantation of severed finger ,and summarize the experience of prevention and treatment.Methods From April 2015 to February 2017,108 patients with wounded finger treated in the First People's Hospital of Yongkang were divided into two groups according to the occurrence of postoperative vascular crisis situation :the control group (56 cases,vascular risk),the observation group (52 cases,vascular crisis happened ).The clinical data of all patients were collected ,the various data were compared , and the causes of vascular crisis were analyzed.The observation group was given low molecular dextran treatment ,the changes of blood coagulation function indicators before and after treatment were observed .Results The age, disconnection plane,ischemia time had statistically significant differences between the two groups ( all P <0.05). After treatment,the four coagulation function index in the observation group [ fiber protease:(3.32 ±0.29) g/L, activated partial thrombin time:(27.56 ±2.08) s,thrombin time:(12.13 ±1.62) s,prothrombin time:(11.47 ± 1.29)s] were improved obviously (t=4.86,8.63,6.04,4.70,all P<0.05).Conclusion The age,disconnection plane and ischemic time are the factors that cause vascular crisis.In addition,postoperative pain, patients'mood, postoperative posture and other factors may also lead to vascular crisis.Preoperative assessment of the condition should be done well,postoperative monitoring should be strengthened ,and prophylactic medication can be used to prevent vascular crisis.
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Interventional bronchoscopy is widely used in histopathological diagnosis of airway disorders.Hemorrhage is the most frequently encountered and difficult-to-manage complication during bronchoscopy,and massive hemorrhage could be life-threatening.There were differences in the incidence of hemorrhage caused by different interventional procedures.At present,the prevention of bleeding induced by intervention is relatively lacking,and the choice of treatment may be not the same in different endoscopy centers.We review the prevention and treatment of hemorrhage complicated by interventional bronchoscopy in this article,which may help to improve the understanding and management ability of hemorrhage during bronchoscopy.
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Objective To investigate efficacy and safety of oral prednisone acetate for prevention of esophageal stenosis after endoscopic submucosal dissection ( ESD) for patients with esophageal precancerous lesions or early esophageal carcinoma. Methods A retrospective analysis was performed on data of 56 patients who underwent circumferential or semi-circumferential ( more than three quarters but not a complete circular) ESD for esophageal precancerous lesions or early cancer in Nanjing Drum Tower Hospital from October 2014 to October 2017. The patients were divided into the study group ( n=26, prednisolone oral administration after ESD ) and the control group ( n=30, without prednisolone oral administration after ESD) . Endoscopic dilatation was performed whenever patients experienced persistent dysphagia to solids. Clinical data, stricture rate, numbers of endoscopic dilatation, and adverse events were compared between the two groups. Results There were no differences in age, gender, location and length of lesions, endoscopic findings, depths of tumor invasion, and pathological subtypes between the two groups ( all P>0. 05) . The proportion of circumferential esophageal lesions in the study group was higher than that in the control group[53. 85% (14/26) VS 23. 33% (7/30), χ2=5. 53, P=0. 02]. The rata of post-procedural esophageal stricture in the study group was significantly lower than that in the control group[ 30. 77% ( 8/26) VS 60. 00% (18/30), χ2=4. 78, P=0. 03], and the number of endoscopic dilatation was lesser in the study group than the control group (3. 85±2. 57 VS 9. 83±5. 82, t =7. 22, P =0. 00). There were no adverse events related to oral prednisone, and no treatment-related mortality. Conclusion Prednisone acetate oral administration is safe and effective to prevent esophageal stenosis after complete or semi-circular ESD for patients with esophageal precancerous lesions or early esophageal carcinoma.
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Objective To evaluate the efficacy and safety of repeated treatments with low-dose rituximab for relapsing neuromyelitis optica spectrum disorder (NMOSD).Methods A perspective study.21 patients who were diagnosed with NMOSD one year ago were recruited for rituximab treatment.Of 21 patients,one was male,20 were females.Onset age was 10-51 years,the mean onset age was (26.2± 12.0) years.Duration of disease was 2.3-25.8 years,the mean duration was (9.2 ± 5.9) years.Best corrected vision activity (BCVA),expanded disability status scale (EDSS),annualized relapsing rate (ARR) were valued to investigate the efficacy and safety of repeated treatments with low-dose rituximab.The BCVA was examined using Snellen chart,and converted to logMAR.The mean BCVA was 1.13 ± 1.09,the mean BCVA in better eyes was 0.4±0.68,the mean BCVA in latter eyes was 1.87±0.90.The mean EDSS was 3.09±0.70.The mean ARR was 1.04± 0.65.All patients underwent two cycles of RTX treatment.The annually induction treatment was RTX 100 mg per week for 4 weeks.Of 21 patients,12 patients had treatment within one month after attack.The mean follow-up period was (28.4±4.9) months.The side effects were recorded,BCVA,EDSS,ARR were valued to investigate the efficacy and safety of repeated treatments with low-dose rituximab.Paired t test,independent sample t test and Chi-squared test were used.Results The mean BCVA at last follow-up was 0.62 ± 0.91,the mean BCVA in better eye was 0.62±0.91,the BCVA in latter eye was 1.0± 1.01.The mean EDSS was 2.26± 1.07.The mean ARR was 0.21 ± 0.3.After the treatment,patient had significant improvement on BCVA in worst eye (t=4.256),ARR (t=2.900),EDSS (t=4.620) with the significant differences (P<0.05).Thirteen relapses in 9 patients were observed.B lymph cells were more than 0.01% in all relapses.There was no significant difference on the BCVA in better eye (t=1.840,P>0.05).There were 9 patients had relapse,13 times in total.Of 13 relapses,B lymph cell count was performed in 12 relapses,and the counts were 0.01%-0.14%.There were no significant difference between relapsed patients and non-relapsed patients on onset age (t=0.67,P=0.51),whether underwent plasma exchange treatment (x2=1.61,P> 0.05),with/without auto-immune antibody ratio (x2=1.61,P> 0.05).Of 21 patients,8 patients had side effects,including 5 patients with infection,4 patients with chest congestion,3 patients with hair losing,2 patients with skin rashes,headache and short of breath,1 patient with tinnitus,palpitation and fatigue.Four patients had more than one symptom.Of all patients who had side effects,slowing down the infusion speed of RTX or infusing 5 mg of dexamethasone could relieve the discomfort.Conclusion Lose-dose rituximab reduces the frequency of NMOSD relapses and is well tolerated.
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Introducción: los factores que modulan la resiliencia actúan como agentes protectores de la salud y pueden influir en el afrontamiento de la enfermedad de los pacientes con cáncer. Objetivo: precisar las particularidades de los factores moduladores de la resiliencia según: optimismo, inteligencia emocional y apoyo social en pacientes diagnosticadas con cáncer de mama. Método: estudio descriptivo, prospectivo, de serie de casos, en el municipio Rodas entre 2014-2015. Incluyó a todas las pacientes diagnosticadas con cáncer de mama, con uno, tres y cinco años de supervivencia. Los instrumentos aplicados fueron: cuestionario de datos generales, examen de inteligencia emocional, cuestionarios de optimismo y de apoyo social. Las variables analizadas fueron: edad, nivel de escolaridad, estado civil, ocupación, presencia de optimismo, grado de inteligencia emocional, necesidad de apoyo. Se realizó un estudio en profundidad y se aplicaron los cuestionarios de datos generales, de optimismo, de apoyo social y examen de inteligencia emocional. Se utilizaron medidas de tendencia central, medidas de dispersión y el porciento como medida de resumen para variables cualitativas. Resultados: se estudiaron 37 mujeres, principalmente casadas, amas de casa, de nivel medio superior y con edad promedio 59,5 años. De los moduladores de la resiliencia, el optimismo estuvo presente en las pacientes con 3 y 5 años de evolución, predominó el grado medio de inteligencia emocional en la mayoría de las pacientes y perciben que necesitan entre casi nada y algo, de apoyo social. Conclusiones: existió homogeneidad en los aspectos sociodemográficos y clínicos de las pacientes. El optimismo estuvo menos presente en los inicios de la enfermedad, pero posteriormente se relacionó con la evolución en años. Las necesidades de apoyo social y emocional aumentaron con el tiempo de evolución de este padecimiento.
Introduction: resilience modulating factors serve as health protecting agents and can influence in facing the disease of patients with cancer. Objective: to specify the distinctive features of modulating resilience factors according to: optimism, emotional intelligence and social support in patients diagnosed with breast cancer. Methods: descriptive, prospective study, of a case series, in the municipality of Rodas from 2014 to 2015. It included all patients diagnosed with breast cancer, with one, three and five years of survival. The applied instruments were: general data questionnaire, emotional intelligence test, optimism and social support questionnaires. The variables analyzed were: age, level of schooling, marital status, occupation, presence of optimism, degree of emotional intelligence, support need. An in-depth study was carried out and the questionnaires of general data, optimism, social support and emotional intelligence examination were applied. Measures of central tendency, dispersion measures and percentage were used as a summary measure for qualitative variables. Results: 37 mainly married, housewives, were studied, senior high schooling and aged 59.5 years average. From the resilience modulators, optimism was present in patients with 3 and 5 years of evolution, an average degree of emotional intelligence predominated in most patients and they perceive that they need between almost nothing and something of social support. Conclusion: there was homogeneity in the socio-demographic and clinical aspects of the patients. Optimism was less present at the beginning of the disease, but later it was related to the evolution in years. Needs of social and emotional support increased with the time of evolution of this condition.
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Abstract This study evaluated the action of ionizing radiation and the possible radioprotective effect of the non-steroidal anti-inflammatory drug meloxicam on the bone physiology of rat mandibles by assessing the alveolar socket healing and bone strength. Forty male Wistar rats were divided in 4 groups (n=10): control (CG), irradiated (IG), meloxicam (MG), meloxicam irradiated (MIG). A dose of 0.2 mg/kg meloxicam was administered to MG and MIG. After this, IG and MIG were irradiated with 15 Gy radiation dose in the mandible. Forty days after the above procedures, the mandibular first molars were extracted and the animals were killed after 15 or 30 days (n=5). Micro-computed tomography and bending test were used to evaluate alveolar socket healing and bone strength, respectively. At 15 days, bone volume, bone volume fraction and trabecular thickness were higher in the CG and MG than in the IG and MIG; and trabecular separation was higher in the IG compared with the others. At 30 days, there was a difference only in trabecular separation, which was higher in IG than in CG and MG, and MIG did not differ from the others. Bone strength was lower in IG compared with CG and MG, and MIG did not differ from the others. In conclusion, the ionizing radiation affected the bone physiology of rat mandibles, delaying the alveolar socket healing and reducing the bone strength. Moreover, the meloxicam had a positive effect on the trabecular separation in alveolar socket healing and on the bone strength.
Resumo Este estudo avaliou a ação da radiação ionizante e o possível efeito radioprotetor do anti-inflamatório não esteroide meloxicam na fisiologia óssea de mandíbulas de rato por meio da análise da reparação alveolar e da resistência óssea. Quarenta ratos Wistar machos foram divididos em 4 grupos (n=10): controle (GC), irradiado (GI), meloxicam (GM), meloxicam irradiado (GMI). Administrou-se uma dose única de 0,2 mg/kg de meloxicam no GM e GMI. Posteriormente, o GI e GMI foram irradiados com dose de 15 Gy na região de mandíbula. Decorridos 40 dias dos procedimentos acima, extraiu-se os primeiros molares inferiores dos animais, que foram mortos após 15 e 30 dias (n=5). Utilizou-se a microtomografia computadorizada e o teste de flexão para avaliação da reparação alveolar e da resistência óssea, respectivamente. Aos 15 dias, o volume ósseo, a fração de volume ósseo e a espessura trabecular foram maiores no GC e GM comparados ao GI e GMI; já a separação trabecular foi maior no GI em relação aos demais. Aos 30 dias, houve diferença apenas na separação trabecular, que foi maior no GI em comparação ao GC e GM, não tendo o GMI diferido dos demais. A resistência óssea no GI foi menor em relação ao GC e GM, não tendo o GMI diferido dos demais. Concluiu-se que a radiação ionizante afetou a fisiologia óssea das mandíbulas de rato, promovendo atraso na reparação alveolar e redução da resistência óssea; além disso, o meloxicam, apresentou efeito positivo na separação trabecular da reparação alveolar e na resistência óssea.