OBJECTIVE:To systematically review the efficacy of α-lipoic acid versus epalrestat in the treatment of diabetic pe-ripheral neuropathy(DPN),and provide evidence-based reference for clinic. METHODS:Retrieved from CJFD,CBM,VIP,Wan-fang Database and PubMed,randomized controlled trials(RCT)about α-lipoic acid versus epalrestat in the treatment of DPN were collected,and the study was screened by inclusion and exclusion criteria. Meta-analysis was performed by using Rev Man 5.3 soft-ware after data extraction and quality evaluation by Cochrane software. RESULTS:Totally 6 RCTs were enrolled,involving 408 pa-tients. Results of Meta-analysis showed,compared with epalrestat,there were no significant differences in the total effective rate [RR=0.98,95%Cl(0.84,1.15),P=0.81],motor nerve conduction velocity [median nerve:MD=1.02,95%Cl(-1.10,3.14),P=0.34;common peroneal nerve:MD=0.23,95%Cl(-1.11,1.58),P=0.73] and sensory nerve conduction velocity [median nerve:MD=1.10,95%Cl(-0.39,2.59),P=0.15;common peroneal nerve:MD=0.95,95%Cl(-1.47,3.36),P=0.44] in α-lipoic acid group. CONCLUSIONS:The efficacy of α-lipoic acid is similar to epalrestat in the treatment of DPN,as well as the motor nerve conduction velocity and sensory nerve conduction velocity of median nerve or common peroneal nerve.

Objective To explore the curative effect of standard craniotomy with large bone flap of the treatment for frontal-temporal severe craniocerebral injury patients.Methods Standard craniotomy with large bone flap was performed on 63 patients with frontal-temporal severe craniocerebral injury.All postoperative patients were followed up.The curative effect was assessed according to GOS.Results All patients were followed up for 1 year.According to the GOS,28 cases recovered well,12 cases became moderately disabled,4 cases were severely disabled,3 cases was in vegetative state and 16 cases died.The mortality rate was 25.4%.Conclusions Standard craniotomy with large bone flap is the best method of the treatment for frontal-temporal severe craniocerebral injury.Timely and thoroughly standard craniotomy with large bone flap for frontal-temporal severe craniocerebral injury patients can significantly improve the the curative effect of the patients and reduce the rate of mortality.

ObjectiveTo investigate the correlation of brainstem auditory evoked potentials(BAEP) and somatic evoked potentials (SEP) with therapeutic outcome of brain stem hemorrhage patients.MethodsBAEP and SEP were detected in the early period of 25 caees with brain stem hemorrhage by evoked potential instrument,and were surveilled dynamically.ResultsThere was good prognosis in the patients whose BAEP and SEP were normal in the first time and repeated detection.Poor prognosis happened in ones whose BAEP and SEP were abnormal in the first time and repeated detection.The difference was significant between them(P＜0.05).ConclusionCombined detection and dynamic surveillance of BAEP and SEP could predict accurately the curative result of patients with brain stem hemorrhage.

This study aimed to compare the safety and effectiveness between unilateral biportal endoscopy (UBE) technique and microscopic decompression (MD) technique in lumbar spinal stenosis treatment. PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, and other databases were used to conduct extensive literature searches. RevMan ver. 5.3 software was used for the statistical analysis. Eleven studies were included with 930 patients, including 449 patients in the UBE group and 521 in the MD group. Both techniques revealed similar operative times at −1.77 minutes (95% confidence interval [CI], −7.59 to 4.05 minutes; p =0.55), the postoperative dural expansion area at −1.27 (95% CI, −19.30 to 16.77; p =0.89), the postoperative complications at 0.76 (95% CI, 0.47 to 1.22; p =0.26), the preoperative Visual Analog Scale (VAS) for leg pain, and the last follow-up (>12 months) VAS for leg pain at −0.04 (95% CI, −0.14 to 0.06; p =0.47), the preoperative Oswestry Disability Index (ODI), and the last follow-up (>12 months) ODI scores at −0.18 (95% CI, −0.76 to 0.40; p =0.54), and patient satisfaction (the modified MacNab score) at 1.15 (95% CI, 0.54 to 2.42; p =0.72). However, intraoperative bleeding was lower following the UBE technique at −52.78 mL (95% CI, −93.47 to −12.08 mL; p =0.01) and was shorter following the UBE technique at −3.06 (95% CI, −3.84 to −2.28; p <0.01). UBE and MD technology have no significant differences in efficacy or safety in the treatment of patients with lumbar spinal stenosis based on this meta-analysis. However, the UBE technique has less intraoperative bleeding and a shorter hospital stay. It has a slight advantage and is a better surgical option than the MD technique. It can be an alternative minimally invasive spinal surgery method.

OBJECTIVE:To systematically review the therapeutic efficacy and safety of modified Taohong siwu decoction in adjuvant therapy of traumatic fracture,and to provide evidence-based reference in clinic.METHODS:Retrieved from CJFD,CBM,Wanfang database and PubMed,related studies about fracture restitution combined with modified Taohong siwu decoction (trial group) vs.fracture restitution alone (control group) in the treatment of traumatic fracture were collected.Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation according to Cochrane systematic review.RESULTS:A total of 6 RCTs and 3 clinical control trials were included,involving 929 patients.Meta-analysis showed that clinical total response rate [RR =1.35,95 ％ Cl (1.24,1.47),P ＜ 0.001] and the incidence of gastrointestinal ADR [RR =5.59,95 ％ Cl (1.30,24.14),P=0.02] in trial group were significantly higher than control group;symptom and sign score [MD =-5.50,95 ％ Cl(-6.45,-4.54),P＜0.001],erythrocyte sedimentation [MD=-13.78,95％ Cl(-15.97,-11.60),P＜0.01],whole blood viscosity [MD=-1.03,95％Cl(-1.11,-0.95),P＜0.001],plasma viscosity [MD=-0.24,95％Cl(-0.27,-0.21),P＜0.01],hematocrit [MD=-12.12,95％Cl(-13.37,-10.86),P＜0.01] and erythrocyte electrophoresis time [MD=-7.12,95％Cl(-7.88,-6.35),P＜ 0.01] of trial group were significantly lower than those of control group,with statistical significance.CONCLUSIONS:For adjunctive therapy of traumatic fracture,modified Taohong siwu decoction can improve clinical efficacy,reduce the inflammatory reaction, improve blood rheology but aggravate gastrointestinal reaction.

OBJECTIVE To investigate the effects and mechanism of luteolin on osteogenic repair of bone defects. METHODS The targets and potential pathways of luteolin in the treatment of bone defects were screened by network pharmacology method， and then the top 2 targets were selected by Hub gene screening for molecular docking verification， with binding energy as the evaluation standard. In vitro experiments were conducted on rat bone mesenchymal stem cells （BMSC） and rat umbilical vein endothelial cells （RUVEC）. Phenotypic validation was performed using alkaline phosphatase staining， alizarin red S staining， and in vitro angiogenesis experiments. Western blot assay was used to detect the protein expressions of phosphatidylinositol 3 kinase （PI3K） and protein kinase 1 （Akt1）， so as to validate the mechanism of luteolin on osteogenic differentiation of BMSC and angiogenesis of RUVEC in vitro. RESULTS The results of network pharmacology showed that the effects of luteolin on vascular formation and bone repair in bone defects were mainly related to Akt1， SRC， estrogen receptor 1， epidermal growth factor receptor， cyclooxygenase 2， matrix metalloproteinase 9 targets， and were closely related to PI3K-Akt signaling pathway. The results of molecular docking showed that luteolin binding to Akt1 and SRC proteins was stable. The results of in vitro experiments showed that luteolin could significantly improve the expressions and activities of alkaline phosphatase in BMSC， increased the number of calcium salt deposits and calcified nodules， and promoted calcification of BMSC. Compared with luteolin 0 μmol/L group， the angiogenesis ability of RUVEC was enhanced significantly in luteolin 1， 10 μmol/L groups， the length of blood vessels and the protein expressions of PI3K and Akt1 were significantly increased （P＜0.05 or P＜0.01）； the higherthe concentration， the better the effect. CONCLUSIONS Luteolin may play a role in promoting angiogenesis and bone repair at the fracture site by activating PI3K/Akt signaling pathway and promoting the protein expressions of PI3K and Akt1.