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OBJECTIVE To investigate the efficacy and safety of different doses of zinc in the treatment of diarrhea in children， and to provide a reference for clinical safe and rational drug use. METHODS Retrieved from PubMed， Cochrane Library， Embase database， randomized controlled trials about zinc （zinc group） versus placebo or conventional treatment （control group） in the treatment of diarrhea in children were collected from the inception to October 2022. Then， the quality of the included literature was evaluated by the Cochrane Handbook 6.0， and meta-analysis and sensitivity analysis were performed by RevMan 5.3 software. RESULTS Finally， 25 RCTs were included， with a total of 8 618 children. The results of meta-analysis showed that in terms of duration of diarrhea， in zinc ＜20 mg group， the zinc group was significantly shorter than the control group [SMD＝ －0.39， 95%CI（－0.71， －0.08）， P＝0.01]， but in subgroups of ＜6 months old， there was no significant difference between the two groups [SMD＝0.01， 95%CI（－0.10， 0.11）， P＝0.88]. In zinc 20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.52， 95%CI（－0.80， －0.23）， P＝0.000 3]. In zinc ＞20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.83， 95%CI（－1.39， －0.27）， P＝0.004]. In zinc ＞10 mg （age ≤12 months） or zinc ＞ 20 mg （age ＞12 months） group （short for “constant dose group”）， the zinc group was significantly shorter than the control group [SMD＝－0.16， 95%CI（－0.27， －0.06）， P＝ 0.003]. In the aspect of diarrhea rate after 7 days of treatment，there was no significant difference in the diarrhea rate after 7 E-mail：lihuiying@etyy.cn days of treatment between the zinc group and the control group： in zinc ＜20 mg group[OR＝1.28，95%CI （0.96，1.70），P＝0.09]， in zinc 20 mg group [OR＝0.40， 95%CI （0.15，1.01），P＝ 0.05]， in constant dose group [OR＝0.64， 95%CI （0.28， 1.44）， P＝0.28]. In terms of vomiting rate， in zinc ＜20 mg group， the vomiting rate of zinc group was significantly higher than that of the control group [OR＝2.13， 95%CI （1.68， 2.70）， P＜0.001]； in constant dose group， vomiting rate of zinc group was significantly higher than that of the control group [OR＝1.84， 95%CI （1.44， 2.34）， P＜0.001]. CONCLUSIONS Zinc can significantly shorten the duration of diarrhea in children（6 months and above）， but low doses can increase the risk of vomiting， which should be taken attention in clinical.
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As one of the hallmarks of cancer, metabolic reprogramming leads to cancer progression, and targeting glycolytic enzymes could be useful strategies for cancer therapy. By screening a small molecule library consisting of 1320 FDA-approved drugs, we found that penfluridol, an antipsychotic drug used to treat schizophrenia, could inhibit glycolysis and induce apoptosis in esophageal squamous cell carcinoma (ESCC). Gene profiling and Ingenuity Pathway Analysis suggested the important role of AMPK in action mechanism of penfluridol. By using drug affinity responsive target stability (DARTS) technology and proteomics, we identified phosphofructokinase, liver type (PFKL), a key enzyme in glycolysis, as a direct target of penfluridol. Penfluridol could not exhibit its anticancer property in PFKL-deficient cancer cells, illustrating that PFKL is essential for the bioactivity of penfluridol. High PFKL expression is correlated with advanced stages and poor survival of ESCC patients, and silencing of PFKL significantly suppressed tumor growth. Mechanistically, direct binding of penfluridol and PFKL inhibits glucose consumption, lactate and ATP production, leads to nuclear translocation of FOXO3a and subsequent transcriptional activation of BIM in an AMPK-dependent manner. Taken together, PFKL is a potential prognostic biomarker and therapeutic target in ESCC, and penfluridol may be a new therapeutic option for management of this lethal disease.
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OBJECTIVE：To systematicall y evaluate the efficacy and safety of a new oral anticoagulant Ⅹ a inhibitor （apixaban，rivaroxaban，edoxaban）in the prevention and treatment of venous thromboembolism （VTE）in cancer patients ，and to provide evidence-based reference for rational use of drugs in clinic. METHODS ：Retrieved from Cochrane Library ，PubMed， Embase，CBM，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about Ⅹa inhibitor （trial group ）versus routine treatment or placebo （control group ）in the prevention and treatment of VTE in cancer patients were collected. After literature screening ，data extraction and quality evaluation was evaluated by using biasrisk evaluation tool recommended by Cochrane System Evaluator M anual 5.1.0，and Meta-analysis was conducted by using Rev Man 5.3 software. RESULTS ：A total of 7 RCTs were included ，including 5 666 patients. Meta-analysis showed that recurrent rate of VTE in trial group was significantly lower than control group [RR ＝0.58，95％CI（0.47，0.71），P＜0.000 01]；there was no statistical significance in the incidence of major bleeding [RR ＝1.12，95％CI（0.67，1.85），P＝0.67] and clinically relevant non-major bleeding [RR ＝1.06，95％CI（0.72，1.55）， P＝0.77] between 2 groups. CONCLUSIONS ：Ⅹa inhibitors can effectively reduce the recurrent risk of VTE in cancer patients ， safety comparable with routine treatment （placebo）.
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Objective:To evaluate the clinical efficacy of thermal-therapy combined with 125 I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen (CEA) and following-up after treatment of the patients with recurrent rectal cancer.Methods:Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with 125I implantation guided by CT (20 cases were treated with operation,but 1 patient was exited who couldn't tolerate the thermal-therapy).Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation,and the distance of the particle was 1.0 cm;all patients received CT scanning and were quantificationally evaluatated after implantation;the number of seeded particles was about 12-58,the radioactivity of the 125I particle was 0.5 mCi,and the matching dose surrounding the tumor was 90-140 Gy.All patients were treated with microwave thermal-therapy after particle implantation,60 min per time,lasting the temprature at 43℃,twice per week,for three weeks.And the patients were followed up after treatment for 3 months,the efficacy was evaluated by image and CEA results,and the urinary frequency,dysuria,hematuria and rectal bleeding were evaluated.Results:Compred with before treatment,after following up for 6 months,the image results showed that the tumor volume was reduced,and the blood CEA level of all patients were decreased from (30.25±8.32) mg · L-1 to (11.89±5.22) mg · L-1 (t=13.158,P＜0.01);the local efficacy was 94.7％ (18/19),and the pain relief rate was 94.4％ (17/18);the NRS median was 6 (4,7) before treatment,and it was 1 (0,3) after treatment,there was significant difference (P＜0.001).There were no frequent urination,urinary pain,hematuria,rectal bleeding and other complications in all patients.Conclusion:Thermal-therapy combined with 125I radioactive particle implantation has good curative effects on the recurrent rectum cancer,and is effective means for recurrent rectum cancer treatment.
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Objective:To evaluate the clinical efficacy of thermal-therapy combined with 125 I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen (CEA) and following-up after treatment of the patients with recurrent rectal cancer.Methods:Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with 125I implantation guided by CT (20 cases were treated with operation,but 1 patient was exited who couldn't tolerate the thermal-therapy).Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation,and the distance of the particle was 1.0 cm;all patients received CT scanning and were quantificationally evaluatated after implantation;the number of seeded particles was about 12-58,the radioactivity of the 125I particle was 0.5 mCi,and the matching dose surrounding the tumor was 90-140 Gy.All patients were treated with microwave thermal-therapy after particle implantation,60 min per time,lasting the temprature at 43℃,twice per week,for three weeks.And the patients were followed up after treatment for 3 months,the efficacy was evaluated by image and CEA results,and the urinary frequency,dysuria,hematuria and rectal bleeding were evaluated.Results:Compred with before treatment,after following up for 6 months,the image results showed that the tumor volume was reduced,and the blood CEA level of all patients were decreased from (30.25±8.32) mg · L-1 to (11.89±5.22) mg · L-1 (t=13.158,P＜0.01);the local efficacy was 94.7％ (18/19),and the pain relief rate was 94.4％ (17/18);the NRS median was 6 (4,7) before treatment,and it was 1 (0,3) after treatment,there was significant difference (P＜0.001).There were no frequent urination,urinary pain,hematuria,rectal bleeding and other complications in all patients.Conclusion:Thermal-therapy combined with 125I radioactive particle implantation has good curative effects on the recurrent rectum cancer,and is effective means for recurrent rectum cancer treatment.
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Objective To explore the application value of remote blood pressure monitoring and health guidance management model in community hypertension patients.Methods 200 hypertension patients were selected from community health service institution between June 2013 and June 2016, and averagely divided into two groups by random number table, 100 cases in each group.The control group was given routine guidance, and the study group was given the remote blood pressure monitoring and online health guidance.The two groups were compared in terms of hypertension knowledge rate and compliance rate, control rate of blood pressure, physical indicators before and after management, including systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), serum creatinine (SCr), triglyceride (TG) and fasting blood glucose (GLU).Results The hypertension knowledge, treatment compliance rate and blood pressure control rate in the study group were 85%, 98%, 86%, and significantly higher than that of 68%, 82%, 57% (P0.05) between the two groups.Conclusion The remote blood pressure monitoring and online health guidance is useful for community hypertension patients.Hypertension knowledge awareness, medication compliance and blood pressure control rate are improved significantly, meanwhile, the patients physical examination indexes can be promoted.
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Objective To evaluate the nursing effect of orientation of traditional Chinese medicine drug therapy combined with multiple frequency vibration therapeutic instrument in treating pediatric pneumonia with dyspneic cough. Methods A total of 277 children (pneumonia with dyspneic cough syndrome of wind-cold invading lung, wind-heat invading, lungphlegm-heat congesting lung) were enrolled in this study. They were divided into the orientation of traditional Chinese medicine drug therapy combined with multiple frequency vibration therapeutic instrument group (lung therapy and sputum excretion group,100 cases), the orientation of traditional Chinese medicine drug therapy group (lung therapy group, 94 cases) and the multiple frequency vibration therapeutic instrument group (sputum excretion group, 83 cases) by random digits table method.The main symptoms improvements, therapeutic evaluation, the comfortable level of the children, family satisfaction degree of the 3 groups were evaluated before and after 5 days of treatment. Results After 5 days, the main symptoms score was (7.22±2.74) points in the lung therapy and sputum vibration group, and (8.98±3.40), (8.78±2.91) points in the lung therapy group and sputum excretion group, there were significant differences among 3 groups, F=9.756, P0.05. The family satisfaction degree in the lung therapy and sputum vibration group was higher than that in the other two groups, and there were significant differences among 3 groups, χ2=9.102, P<0.05. Conclusions The nursing effect of orientation of traditional Chinese medicine drug therapy combined with multiple frequency vibration therapeutic instrument has more advantages in treating pediatric pneumonia with dyspneic cough.
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Objective:To study whether sacral lymph nodes should be included in the target volume delineation for those patients with early (stageⅠB-ⅡA) uterus cervix cancer during postoperative radiotherapy. Methods:Forty-six patients with early uterus cervix cancer were given postoperative three dimensional conformal radiation therapy (3D-CRT) in our department for one month after radical resection. The patients were randomly divided into two groups. The sacral lymph nodes were not included in the target volume delineation in the treatment group. But they were delineated in control group. All the patents had no radiotherapy-related contraindications and signed the consent agreement. The patients were followed up. The local controlling rate and the incidence and degree of radioactive proctitis were compared between the two groups. Results:The local controlling rate of the two groups had no significant difference(t=0.000, P=1.000). The doses received by the 5% and 95% volume of the rectum(V_5, V_95), the average dose, and the minimum dose had significant difference between the two groups(t_(V5)=2.169, P_(V5)=0.041; t_(V95)=4.036, P_(V95)=0.001;t_(mean)=2.236, P_(mean)=0.036; t_(min)=2.265, P_(min=0.034), but the maximum dose received by the rectum had no obvious difference (t_(max)=0.518, P_(max)=0.610). The incidence of radioactive proctitis had significant difference between the two groups(t=2.174, P=0.190). Conclusion:For the early uterus cervix cancer patients who have recurrent risk after radical surgery, sacral lymph nodes should not be included in the delineation of target volume during 3D-CRT in order to decrease the incidence of radioactive proctitis.
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Objective To construct secreting type human TRAIL(shTRAIL) gene vector pcDNA3.1-HRE/Egr1-shTRAIL mediated by hypoxia/radiation double sensitive promoter,and observe the effect of hypoxia and radiation on shTRAIL.Methods HRE upper and lower strands were gotten by chemical synthesis,double strands HRE was gotten by PCR;pMD19T-Egr1 was digested by SacⅠ and Hind Ⅲ,then Egr1 was obtained,pshuttle-shTRAIL was digested by Kpn Ⅰ and BamH Ⅰ,then shTRAIL was obtained;HRE/Egr1 double sensitive promoter mediated shTRAIL expression vector pcDNA3.1-HRE/Egr1-shTRAIL was constructed by gene recombination technique,it was identified correctlly by enzyme digestion,PCR and sequencing.A549 cells were divided into normal,hypoxia(0.1%),irradiation(6 Gy) and hypoxia + irradiation groups.Results After enzyme digestion by BamH Ⅰ and Sma Ⅰ,the fragments which lengthes were 1284 bp and 4 998 bp,2 292 bp and 3 990 bp were obtained;the vector was amplified by PCR with Egr1 and shTRAIL primer,the products which lengthes were 469 bp and 820 bp were obtained;pcDNA3.1-HRE/Egr1-shTRAIL was sequenced,the result was same to designed,this demonstrated that the construction was right.The vectors were transfected into A549 cells of adenocarcinoma of lung,the expression levels of shTRAIL mRNA and protein were increased after treated with hypoxia and radiation,it had statistically significant differences compared with normal group(P
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Objective To study the security of low dose and half-body irradiation by 60Co ?-rays as a new method of clinical radiotherapy.Methods The simulated manikin was used to simulate human body and two radiation modalities of facing and backing on radioactive source were adopted.Half-body irradiation was done by 60Co ?-rays with doses of 9,10 and 11 cGy.The exposure dose of every layer and important target organs in the simulated manikin were detected,and the security of low dose and half-body irradiation as a therapeutic method was evaluated.Results The exposure dose of every layer and sensitive organs were all within safety margin,when simulated manikin facing or backing on the radioactive source was irradiated by 60Co ?-rays with doses of 9,10 and 11 cGy.Further,the exposure dose of sensitive organs in the simulated manikin backing on the radioactive source was lower than that in those facing the radioacive source.Conclusion The method of low dose and half-body irradiation as a radiotherapeutic method is safe and feasible and the radiation modality of backing on the radioactive source is more safe.
