Compression Stockings for Prevention of Postthrombotic Syndrome: A Systematic Review and Meta-Analysis.

OBJECTIVE: The present meta-analysis aimed to evaluate the efficacy and safety of compression stockings for postthrombotic syndrome (PTS) prevention in patients with deep venous thrombosis (DVT). METHODS: Randomized controlled trials (RCTs) regarding the use of compression stockings for prevention of PTS were identified from the Medline, PubMed, and Embase databases as well as the Cochrane library. The resulting manuscripts were analyzed according to the criteria in the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Six RCTs involving 1465 patients with DVT were included. The meta-analysis indicated no statistical differences between the compression stocking and the control groups in PTS incidence, using either the Villalta scale (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.23-1.74) or the Ginsberg scale (OR, 1.13; 95% CI, 0.72-1.77). Based on the Villalta scale categorization, there were no differences in the incidence of mild-moderate PTS (OR, 0.71; 95% CI, 0.36-1.41) or incidence of severe PTS (OR, 0.68; 95% CI, 0.15-3.11). The difference in the recurrence of venous thromboembolism (OR, 0.89; 95% CI, 0.61-1.30) was also not significant. In the 3 RCTs that reported side effects of compression stockings, they were primarily related to discomfort, including itching, erythema, and rash. CONCLUSION: The present meta-analysis has indicated that compression stockings may not prevent PTS, as determined by either the Villalta or the Ginsberg scale, in patients with DVT. However, owing to the limited number of trials, the evidence is not strong enough to draw a reliable conclusion. Further larger, randomized, double-blind, placebo-controlled, multicenter trials are needed.

Pleural mesothelial cells promote expansion of IL-17-producing CD8+ T cells in tuberculous pleural effusion.

IL-17-producing CD8(+) T lymphocytes (Tc17 cells) have recently been detected in many cancers and autoimmune diseases. However, the possible implication of Tc17 cells in tuberculous pleural effusion remains unclarified. In this study, distribution and phenotypic features of Tc17 cells in both tuberculous pleural effusion (TPE) and peripheral blood from patients with tuberculosis were determined. The effects of proinflammatory cytokines and local accessory cells (pleural mesothelial cells) on Tc17 cell expansion were also explored. We found that TPE contained more Tc17 cells than the blood. Compared with IFN-γ-producing CD8(+) T cells, Tc17 cells displayed higher expression of chemokine receptors (CCRs) and lower expression of cytotoxic molecules. In particularly, Tc17 cells in TPE exhibited high expression levels of CCR6, which could migrate in response to CCL20. Furthermore, IL-1ß, IL-6, IL-23, or their various combinations could promote Tc17 cell expansion from CD8(+) T cells, whereas the proliferative response of Tc17 cells to above cytokines was lower than that of Th17 cells. Pleural mesothelial cells (PMCs) were able to stimulate Tc17 cell expansion via cell contact in an IL-1ß/IL-6/IL-23 independent fashion. Thus this study demonstrates that Tc17 cells marks a subset of non-cytotoxic, CCR6(+) CD8(+) T lymphocytes with low proliferative capacity. The overrepresentation of Tc17 cells in TPE may be due to Tc17 cell expansion stimulated by pleural proinflammatory cytokines and to recruitment of Tc17 cells from peripheral blood. Additionally, PMCs may promote the production of IL-17 by CD8(+) T cells at sites of TPE via cell-cell interactions.

[Effects of guan-mai-shu on tissue-type plasminogen activator and plasminogen activator inhibitor in the plasma of patients with coronary heart disease].

Effects of Guan-Mai-Shu (GMS), a traditional Chinese medicine preparation, on tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) in the plasma of patients with coronary heart disease were studied. It was found that those patients had a significant decrease in t-PA activity (P < 0.05) and a significant increase in PAI activity (P < 0.01) compared to healthy subjects. After treatment of GMS, t-PA activity significantly increased (P < 0.001), while PAI activity decreased (P < 0.001). These results indicated that GMS could raise t-PA activity and reduce PAI activity in the plasma of patients with coronary heart disease.

Changes in the positive and negative symptoms of schizophrenic in-patients in China.

Positive and negative symptoms at admission and discharge of 401 unselected schizophrenic patients from four psychiatric hospitals around China were studied. On admission 58% of patients had prominent negative symptoms and the overall severity of negative symptoms was similar to that of positive symptoms; at discharge, negative symptoms were more prevalent and more severe. The severity of negative symptoms was not significantly correlated with duration of illness or with dosage of medication; 48% of first-episode, drug-naive patients had prominent negative symptoms on admission. Negative symptoms responded to standard neuroleptic treatment, but the improvement was less marked than that in positive symptoms (47% v. 80%). The proportion of patients classified as positive type, negative type, and mixed type schizophrenia altered dramatically with treatment. These findings highlight the importance of negative symptoms in the assessment and treatment of both acute and chronic schizophrenia.

[Correlation of pulmonary hemodynamics and electrical impedance pulmonary rheogram].

Pulmonary hemodynamic was taken in 16 patients with pulmonary hypertension (PH) and in 18 patients without pulmonary hypertension (NPH) and contrasted simultaneously with their electrical impedance rheogramm (IPR). The parameters of the pulmonary hemodynamic: PASP, PADP, PAMP, TPR, CpA had significant difference between PH and NPH, but there was no significant difference in SVI and CI between PH and NPH. The parameters in IPR: Q-B, B-Y, Q-B/B-Y, B-C, Hs, Cdz/dtmax had significant difference between PH and NPH. The correlation between the parameters in IPR and pulmonary hemodynamic were remarkable, their coefficient of correlation were 0.332-0.72. The regressional equation of PAMP was as follows: PAMP (mmHg) = 32.64-36.8Hs-110.432Q-C+31.208Q-B/B-Y. F = 15.33, S = 6.24, P less than 0.01. The clinical effect of the equation for the calculation of PAMP was satisfactory.

[Predictive impact on malaria prevalence by hydraulic project of three gorges of the Yangtze River].

Malaria had a wide distribution and high prevalence throughout the Three Gorges region of the Yangtze River. After antimalarial program, its incidence rate was reduced to 2.2% in 1985, but sporadic cases still occurred in 34.7% of the townships and local outbreaks were not uncommon. Therefore, potential factors of malaria outbreak are still present. It is predicted that maximum risk of malaria outbreak will take place, during construction and after the completion of the reservoir, the breeding sites of Anopheles would be extended to irrigation network, low-lying of flooded land, and malaria prevalence might be increased.