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Objective To analyze the clinical characteristics of 310 patients with anti-tuberculosis drug-induced liver injury(ATB-DILI),to explore prognostic influencing factors,and to provide reference for its prevention and treatment.Methods Primary tuberculosis patients hospitalized in the Department of Tuberculosis of the Third People's Hospital of Kunming from November 2020 to November 2022 who met the diagnosis of ATB-DILI were enrolled.Statistics by gender,age,history,type of tuberculosis,co-morbidities,frequency of anti-tuberculosis regimens leading to liver injury,use of hepatoprotective drugs,and management and regression were performed to analyze the clinical characteristics of the patients and the factors influencing their prognosis.Results 310 patients were included,male,148(47.74%)and female,162(52.26%).The mean age was 44.33±17.47 years.Thirty-four patients had a history of allergy.The combination of isoniazid,rifampicin,pyrazinamide,and ethambutol(244 patients,78.71%)was the anti-tuberculosis regimen that resulted in the highest number of cases of hepatic injury.The median time between initiation of the tuberculosis regimen and the development of hepatic injury in patients with ATB-DILI was 30 d,and the mean duration of hospitalization was 16.39±7.01 d.The most used hepatoprotective drug was reduced glutathione(154 patients,49.68%),and most patients used a combination of 2 hepatoprotective drugs(128 patients,41.29%).Liver injury improved in 257 cases(82.90%)and failed in 53 cases(17.10%).The differences in alcohol consumption,severity,clinical staging,TT,ALP,TBIL,DBIL,IBIL,and GGT were statistically significant compared to those who did not recover(P<0.05),and severity and high ALP were independent risk factors for poor prognosis.Conclusions Patients should be carefully asked if they have a history of basic liver disease and alcoholism before using anti-tuberculosis drugs.In the course of anti-tuberculosis treatment,the combined use of anti-tuberculosis drugs is more serious than the use of single drugs to cause liver damage.Drugs that may cause liver damage should be used with caution and improved anti-tuberculosis programs should be explored.At the same time,liver function should be monitored regularly during anti-tuberculosis treatment,especially 30 days after medication,in order to reduce the occurrence of adverse reactions.
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Objective:To investigate the characteristics and differences in clinical efficacy of proprioceptive neuromuscular facilitation(PNF)and lower limb robotics in improving lower limb motor function,walking speed,and auto-matic balance function in stroke patients. Method:Seventy-two stroke patients with hemiplegia who met the criteria were randomly assigned to the con-ventional group(n=25),PNF group(n=24),and lower limb robotics group(n=23).The treatment lasted for 4 weeks.Before and after treatment,the Fugl-Meyer assessment lower extremity scale(FMA-LE),10m maxi-mum walking speed test(MWS),and neuro com balance manager system were used to evaluate lower limb movement function,walking speed and automatic balance function. Result:After 4 weeks of treatment,the FMA-LE score of PNF group was significantly better than that of conventional group(P＜0.05)and lower limb robotics group(P-0.001),the MWS score in the lower limb ro-botics group was significantly better than that in the conventional group(P＜0.05)and the PNF group(P=0.001),and the MWS score in the PNF group was significantly better than that in the conventional group(P＜0.05).The lower limb robotics group showed significantly better scores in the reaction time,movement veloci-ty,endpoint travel distance,maximum excursions and directional control index score than the conventional group(P＜0.05)and the PNF group(P＜0.05),while the directional control index score in the PNF group was significantly better than that in the conventional group(P=0.049). Conclusion:Manual PNF therapy and lower limb robotics training have their own clinical efficacy in stroke patients,with PNF technique being more effective in improving lower limb motor function,while lower limb robotics have an advantage in automatic balance function and walking speed.
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Objective:To observe any effect of dry needling of myofascial trigger points on substance P and synaptophysin expression in the spinal dorsal horn.Methods:Sixty-four Sprague-Dawley rats were randomly divided into a control group ( n=16) and a model group ( n=48). Myofascial trigger points were induced in the model group by a blunt strike and eccentric running. That group was then randomly divided into a no-treatment group ( n=15), a massage group ( n=16), and a dry needling group (16 rats). The rats in the two treatment groups received 4 weeks of dry needling or Chinese massage. Pressure pain thresholds were recorded before the experiment and after the 4 weeks. The content of substance P and synaptophysin in the spinal dorsal horn were measured using immunoblotting and immunohistochemistry. Results:After the treatment 14 rats (93%) in the model group had trigger points, significantly higher than the 8 rats (50%) in the massage group and the 7 rats (44%) in the dry needling group. After treatment, the average pressure pain thresholds of the no-treatment and massage groups was significantly lower than the control group′s average, while the difference between the dry needling group and the control group was not significant. The average pressure pain threshold had improved significantly in the no-treatment group, the massage group and the dry needling group, and the averages of the massage group and the dry needling group were significantly higher than that of the no-treatment group. The level of substance P was significantly higher in the no-treatment group than in the other three groups and the ratio of substance P to Glyceraldehyde 3-phosphate dehydrogenase (GAPDH)was significantly higher. The substance P: GAPDH ratio of the massage group was significantly higher than that of the control group.Conclusions:Dry needling and massage are effective in relieving myofascial pain, at least in rats. Both can reduce the content of substance P in the spinal dorsal horn.