[Clinical study of different adsorbents with dual plasma molecular adsorption system in the treatment of hepatic failure].

Objective: To investigate the effects of two different sorbents(Carbon perfusion apparatus and Resin perfusion apparatus)in Double plasma molecular absorb syetem for liver failure treatment. Methods: A total of 152 cases with liver failure who were admitted to The Sixth People's Hospital of Zhengzhou, from June 2016 to May 2018 were selected and divided into DPMARS Carbon group (77 cases) and Resin group (75 cases). The two groups were observed in terms of liver function, prothrombin activity(PTA),Plasma albumin ,tumor necrosis factor alpha and interleukin-6 were detected and compared between the two groups before and after treatment. Results: ①The clinical symptoms improved in different degree in two groups, the recovery rate of Carbon cans Carbon perfusion apparatus group and Resin group separately were89.6% (69/77)、90.7% (68/75)(χ(2) = 0.048, P = 0.975), there were no statistical differences. There were no statistical differences between the two groups in untoward reactions(χ(2) = 0.235, P = 0.995), ②Compared with before treatment, TBil(t = 3.735, 3.728; P = 0.000, 0.000)、ALT(t = 5.117, 5.203; P = 0.000, 0.000)、TNF-α (t = 3.158, 3.094; P = 0.000, 0.002)、IL-6(t = 3.647, 3.559; P = 0.002, 0.003)decreased and ALB (t = 2.300, 3.065; P = 0.024, 0.003) increased significantly after treatment in both groups, and there were statistical differences. There were no signifiant differences in the changes in ALB(t = 0.316, 0.209; P = 0.657, 0.720) and PTA(t = 0.810, 0.843; P = 0.429, 0.516). ③After treatment, there were no signifiant differences in the changes in TBil、ALT、ALB、PTA、TNF-α、IL-6(t = 0.377、0.904、-1.133、-1.552、0.841、0.401; P = 0.952、0.283、0.826、0.094、0.154、0.457). Conclusion: Double plasma molecular absorb syetem is effective in treating liver failure. Carbon perfusion apparatus or Resin perfusion apparatus can be combined with Specific bilirubin adsorption column for DPMARS in clinical treatment,and their effects are similar.

[Advances in the treatment of primary biliary cholangitis].

Primary biliary cholangitis (PBC) is an autoimmune liver disease mainly involving intrahepatic interlobular bile ducts and can progress to liver fibrosis, liver cirrhosis, and even liver failure. Ursodeoxycholic acid (UDCA) is the first-line therapeutic drug for PBC and can delay disease progression, but as high as 40% of patients have suboptimal response to UDCA. Obeticholic acid, a farnesoid X receptor agonist, has been approved by FDA in May 2016 for patients who have no response to UDCA treatment or cannot tolerate such treatment. Other drugs such as fibrates, glucocorticoids, immunosuppressants, biological agents, and mesenchymal stem cells are gradually used in clinical practice and bring new hope to patients with refractory PBC.

Field cancerization treatment using topical photodynamic therapy: A comparison between two aminolevulinate derivatives.

The objective of this study was to evaluate and compare the clinical response to PDT (Photodynamic Therapy) in field cancerization using two aminolevulinate derivatives. Forty patients with multiple actinic keratosis (AK) on forearms and hands scattered received two sessions of ALA and MAL-PDT at 630 nm (36 J/cm2). The AK clearance rate was 72 % for both drugs with a significant decrease in AK observed clinically (p < 00,001). Clinical improvement in field cancerization using two aminolevulinate derivatives in PDT is proven with no significant difference in the efficacy of drugs.

Best practice in the management of benign prostatic hyperplasia in the patients requiring anticoagulation.

In today's aging population, urologists are often treating older patients with multiple comorbidities. Lower urinary tract symptoms from benign prostate hyperplasia (LUTS/BPH) is a common condition that affects men, with increasing prevalence as men age. In a subset of patients, the symptoms are too severe or refractory to medical therapy and, therefore, surgical therapy is required to improve their LUTS. The use of medical therapy often delays the need to intervene surgically in men with LUTS/BPH and with advances in the management of cardiovascular disease, urologists are increasingly encountering more men requiring BPH surgery on chronic anticoagulation therapy. The decision of when to offer surgical intervention and how to manage anticoagulation medication in the perioperative setting is a dilemma with which surgeons are dealing with increasing frequency. The purpose of this review is to clarify the optimal approach to the surgical patient with LUTS/ BPH requiring anticoagulation therapy.

Successful treatment of fulminant pulmonary embolism with extracorporeal life support and simultaneous systemic thrombolytic therapy after 1 h of cardiopulmonary resuscitation.

Here we describe a patient with a fulminant pulmonary embolism, who has been successfully treated with an extracorporeal life support system and simultaneous systemic thrombolytic therapy after 1 h of cardiopulmonary resuscitation.

Terapia Floral: uma revisão integrativa da literatura / Floral Therapy: an integrative literature review

Atualmente, o Sistema Único de Saúde (SUS) oferece, de forma integral e gratuita, 29 procedimentos de Práticas Integrativas e Complementares em Saúde (PICS) à população. Dentre elas está a terapia floral, uma das PICS reconhecida pela Organização Mundial da Saúde desde 1956, que visa tratar questões voltadas ao bem-estar emocional e consequentemente, da saúde corpo-mente, indo ao encontro aos preceitos estabelecidos pelo SUS. O presente trabalho realizou uma revisão integrativa da literatura sobre a eficácia da terapia floral. Foram feitas buscas no PubMed/MedLine e selecionados 44 artigos, frutos de estudos experimentais. Tratase de um campo de pesquisa muito novo, com a publicação do primeiro artigo indexado em 1999; maior número de publicações entre 2012 e 2014; predomínio de publicações em revistas cubanas (73%) e, portanto o idioma predominante foi o espanhol. Os temas de predominância de publicação foram: climatério e estresse com 5 artigos cada um, seguidos de 3 publicações sobre transtorno de atenção e outros 3 sobre ansiedade; a maioria das pesquisas foram realizadas em hospitais e em instituições de ensino superior. Quanto à somatória do total de participantes das pesquisas de acordo com os temas de maior publicação tem-se: climatério com 417 participantes; ansiedade 195; estresse 149; transtorno de atenção 140; hipertensão arterial 100; câncer 112; cirurgia 73; medo e trauma 67. Predominância de estudos estatisticamente significativos, 27 do tipo "ensaio cli?nico controlado" e 17 "ensaios clínicos não-controlados". Dois ensaios cli?nicos foram realizados em animais, o que evidencia o cuidado diante da metodologia utilizada para comprovar a eficácia do tratamento com essências florais sem que haja o fator sugestionamento do efeito placebo, muitas vezes, questionada em pesquisas com seres humanos. Quanto à pergunta de pesquisa: 40 dos 44 artigos (90,1%) obtiveram eficácia do tratamento com as essências florais e apenas um trabalho não obteve eficácia no tratamento com terapia floral, os demais obtiveram eficácia parcial. Os dados indicam uma produção preocupada em relatar trabalhos de pesquisa baseada em evidência, seguindo modelos que atendam a padrões de pesquisa internacionalmente aceitos. Embora a maioria das pesquisas tenha apresentado resultados favoráveis, são necessários mais estudos que sirvam como referencial para as PICS e, na medida em que a terapia floral se apresenta como possibilidade de intervenção em saúde tanto no SUS como no setor privado, é importante pensar na formação dos profissionais em terapia floral. Assim, como produto educacional deste estudo foi proposto um projeto pedagógico para um curso de pós-graduação em terapia floral, nos preceitos da interdisciplinaridade e multiprofissionalidade, com vistas a contribuir ao conhecimento e embasamento científico sobre o tema, para fortalecer e divulgar esta prática terapêutica.

Eficacia del tratamiento con acupuntura en pacientes con várices en miembros inferiores / Effectiveness of acunpuntural treatment in patients with varicous veins in the lower limbs

Se realizó un ensayo clínico fase II temprana abierto y secuencial en 80 pacientes con várices en miembros inferiores que fueron remitidos, desde el Servicio de Angiología al de Medicina Natural y Tradicional del Hospital Provincial de la Ciudad de Camagüey desde marzo hasta agosto de 1999. Se comprobó la eficacia de la terapéutica a partir de la quinta sesión de tratamiento, alcanzando significaciones estadísticas relevantes a la décima. El 93.75% de pacientes presentó una buena evolución. Desapareció el edema, la pesadez y la parestesia en el 100 % de los enfermos. Demostró además ser una terapéutica de corta duración, de elevado beneficio y reincorporación social rápida, sin reacciones adversas.

A clinical, phase II open, early and sequiential essay was performed in 80 patients with varicous veins of lowe limbs. They were remitted from the Angiology Service to the natural and Traditional Service of the Provincial Hospital Camagüey City within the period from March to August 1999. The importance of this treatment was proved in the fifth session, and statistic significance was reached at the tenth. The 93,75% of patients had a goog evolution. Swelling, heainess and parestesia disappeared in 100% of patiens . It was also short term therapeutic , of great and rapid social reicorporation withouh adverse reactions.