Postoperative epidural adhesion is one of the most common causes of failed back surgery syndrome (FBSS), which can lead to back and leg pain or neurological deficit. Prevention of epidural adhesion after laminectomy is critical for improving the outcomes of lumbar surgery. The main origins of epidural fibrosis are raw surface of erector muscles and rupture fibers of intervertebral disc. The main current preventive methods for epidural adhesion include the usage of implants, chemicals and low dose radiation. However, most of them are still in experiment period. There are still controversies on the clinic usage of autograft free fat, ADCON-L, and Mitomycin C (MMC). The optimal implants are characteristics of better biocompatibility, degradable absorption and capability of existing for a certain period in body. The optimal medicine should have good effect on anti-desmoplasia, less side effects and long half-life. Besides, the combination of biodegradable medical film and drug and the mixture of two or more medical films are also the research frontlines of epidural adhesion. Further researches are required to explore new materials and drugs with stable and most favorable effect in preventing epidural adhesion.
Biocompatible Materials ; administration & dosage ; Epidural Space ; pathology ; Humans ; Laminectomy ; adverse effects ; Lumbar Vertebrae ; surgery ; Tissue Adhesions ; prevention & control

Background Increase of lens thickness at incipient cataract is a key factor of onset of primary angle-closure glaucoma (PACG).Phacoemulsification (Phaco) or phacotrabeculectomy (Phacotrabe) have been documented to be effective for the patients of PACG associated with cataract.However,which surgery is more effective and safe is lack of evidence.Objective This study was to assess and compare the clinical effectiveness of Phaco versus Phacotrabe for PACG with cataract.Methods The relevant literature was searched electronically from the PubMed (1966 to June 2011),EMB Reviews (1966 to June 2011) and Cochrane Library (Issue 1,2011).The manually searching of relevant conference proceedings was used as the supplement.The articles of randomized controlled trial (RCT) about the clinical effectiveness of Phaco versus Phacotrabe for PACG with cataract were included.The methodology quality of included literature was graded.The analysis indexes included intraocular pressure (IOP)-lowing range,postoperative administration of glaucoma drugs,incidence of positive complication,postoperative best corrective visual acuity (BCVA) and perimetry damage.The RevMan4.2 software from Cochrane Collaboration was used for the Meta analyses.Results Three RCTs about phaco versus Phacotrabe for PACG with cataract were selected in this study with the 164 eyes of 164 cases.Meta analysis showed that the IOP-lowing range was larger in the Phacotrabe group compared to only Phaco group with the WMD of 1.17 and 95％ CI of 0.06-2.27 (P =0.040),and the drug dosage of anti-glaucoma was less in the Phacotrabe group in comparison with the Phaco group with the WMD of 0.5 and 95％ CI of 0.24-0.77 (P =0.000).However,the incidence of postoperative complication was higher in the Phacotrabe group than that of the Phaco group with the RR of 0.08 and 95％ CI of 0.02-0.33 (P =0.000).No significant difference was found in the BCVA (WMD =0,95％ CI:-0.13-0.13,P=1.00) andperimetry (WMD =1.01,95％CI:0.56-1.82,P=0.98).Conclusions Compared with Phaco,Phacotrab has a better IOP-lowing effectiveness and slightly worse safety.Phaco and Phacotrab have a fairly influencc in the postoperative BCVA and perimetry.As the sample sizes of the included trials are relatively small,more welldesigned large-scale RCTs are needed.

Objective:To study the practical value and imaging expression of target reconstruction technique of HRCT in the diagnosis of pneumoconiosis.Methods:Fifty-seven cases with different level type of pneumoconiosis were first examined by routine CT scan,followed by HRCT examination at top of aortic arch,carina of trachea,3 cm below bifurcation of bronchi,and 2 cm above thd right diaphragm.Target reconstruction have been finished using the raw data stored.Results:Target reconstruction photoimages were cleared to display the morphology of delicate lesions of pneumoconiosis:(1)Nodular shape(100%).(2)Interlobular septal thickening(98.24%).(3)Lobular structure abnormality(98.24%).(4)Subpleural nodes (84.21%).(5)Centrilobular emphysema(63.15%).(6)Subpleural line(64.91%).(7)Bronchiectasis(63.15%).(8)Ground-glass opacity(35.08%).(9)Honeycombing(15.78%),and to display earlier period change details.Conclusion:HRCT target reconstruction technique may make lesion dispaly more detail than comventional and high-resblution CT.It is reliable to display the delicate lesions of pneumoconiosis and provide more diagnostic information.

OBJECTIVETo investigate the molecular mechanisms underlying in the treatment of inflammatory bowel disease by Pulsatilla Decoction.

METHODSForty Wistar male rats were randomly divided into 5 groups( n = 8)control group, model group, model + positive control group (mesalazine), Pulsatilla Decoction treatment group, in addition, the Pulsatilla Decoction treatment group was divided into middle and high dose group. Intragastric administration was used in the positive control group and Pulsatilla Decoction treatment group. The expression of interleukin-1beta (IL-1beta), interleukin-6(IL-6) and tumor necrosis factor-alpha (TNF-alpha) were detected by real time PCR after extraction of RNA from colons.

RESULTSCompared with the model group, positive medicine and Pulsatilla Decoction group, especially high-dose group, could effectively inhibit the expression of IL-1beta, IL-6 and TNF-alpha.

CONCLUSIONPulsatilla Decoction could exert its effect in the treatment of inflammatory bowel disease by inhibiting the expression of proinflammatory cytokines.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Inflammatory Bowel Diseases ; drug therapy ; metabolism ; Interleukin-1beta ; genetics ; metabolism ; Interleukin-6 ; genetics ; metabolism ; Male ; Phytotherapy ; Pulsatilla ; chemistry ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

OBJECTIVETo evaluate the effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia based on current clinical evidence.

METHODSWe searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CNKI, VIP, CBM and Wanfang Database from the establishment to April 2014 for the published literature on the treatment of idiopathic oligoasthenozoospermia with L-carnitine. We conducted literature screening, data extraction, and assessment of the methodological quality of the included trials according to the inclusion and exclusion criteria, followed by statistical analysis with the RevMan 5. 2 software.

RESULTSSeven randomized controlled trials involving 751 patients with idiopathic oligoasthenozoospermia met the inclusion criteria, and 678 of them were included in the meta-analysis. L-carnitine treatment achieved a significantly increased rate of spontaneous pregnancy as compared with the control group (RR = 3.2, 95% CI 1.74 to 5.87, P = 0.0002). After 12-16 and 24-26 weeks of medication, total sperm motility (WMD = 5.21, 95% CI 2.78 to 7.64, P < 0.0001 and WMD = 9.29, 95% CI 1.28 to 17.29, P = 0.02) and the percentage of progressively motile sperm (WMD = 12.44, 95% CI 4.58 to 20.31, P = 0.002 and WMD = 9.76, 95% CI 3.56 to 15.97, P = 0.002) were remarkably higher than those in the control group, but no statistically significant differences were observed in sperm concentration between the two groups (WMD = 4.91, 95% CI -2.63 to 12.45, P = 0.2 and WMD = 0.93, 95% CI -3.48 to 5.34, P = 0.68). After 12-16 weeks of treatment, the percentage of morphologically abnormal sperm was markedly decreased in the L-carnitine group as compared with the control (WMD = -2.48, 95% CI -4.35 to -0.61, P = 0.009), but showed no significant difference from the latter group after 24-26 weeks (WMD = -4.38, 95% CI -9.66 to 0.89, P = 0.1). No statistically significant difference was found in the semen volume between the two groups after 12-16 or 24-26 weeks of medication (WMD = -0.13, 95% CI -0.43 to 0.18, P = 0.42 and WMD = 0.28, 95% CI -0.02 to 0.58, P = 0.07). No serious L-carnitine-related adverse events were reported in 4 of the randomniized controlled trials.

CONCLUSIONThe current evidence indicates that L-carnitine can improve spontaneous pregnancy and semen parameters in the treatment of idiopathic oligoasthenozoospermia, with no serious adverse reactions.

Asthenozoospermia ; drug therapy ; Carnitine ; adverse effects ; pharmacology ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Randomized Controlled Trials as Topic ; Semen Analysis ; Sperm Count ; Sperm Motility

OBJECTIVETo observe the effect of Wendan Xiezhuo method (WXM) on carotid arteriosclerosis and vascular endothelial diastolic function in essential hypertension (EH) patients with turbid-phlegm syndrome (TPS).

METHODSForty-three EH patients of medium and low risk with TPS were randomly assigned to two groups, the Wendan Tablet (WT) group (23 cases) and the placebo group (20 cases), they were treated with WT and placebo respectively on the base of amlodipine treatment to control the blood pressure. Carotid intimamedia thickness (IMT), atherosclerotic plaque score of carotid artery, endothelium-dependent dilation (EDD) and flow-mediated vasodilation (FMD) of brachial artery after taking nitroglycerin were detected with ultrasonography before and after 6 months of treatment.

RESULTSAs compared with those in the placebo group, in the WT group after treatment, scores of TPS and carotid plaque were better, area of carotid plaque was lesser and IMT was lower significantly (P<0.05 or P<0.01). There was a negative correlation between brachial artery EDD and carotid IMT in EH patients with TPS (r = - 0.596, P < 0.05). After treatment EDD was improved more significantly in the WT group than that in the placebo group, however, no significant difference was found in non-endothelium-dependent dilation between the two groups.

CONCLUSIONA negative correlation exists between brachial artery EDD and carotid IMT, and the latter could be aggravated by TPS in EH patients. WXM shows favorable effects in improving carotid plaque and EDD.

Aged ; Atherosclerosis ; complications ; pathology ; physiopathology ; Carotid Arteries ; diagnostic imaging ; drug effects ; physiopathology ; Carotid Artery Diseases ; complications ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; pathology ; physiopathology ; Female ; Humans ; Hypertension ; complications ; drug therapy ; pathology ; Male ; Middle Aged ; Phytotherapy ; Syndrome ; Treatment Outcome ; Ultrasonography

OBJECTIVETo study the effects of Shexiang Baoxin Pill (SBP) in treating carotid atherosclerosis (CAS).

METHODSForty-one CAS patients were randomly assigned to 2 groups, the SBP group (31 cases) treated with SBP plus routine treatment and the control group (10 cases) with routine treatment only. Both were treated for 6 months. The changes of carotid atheromatous plaque (CAP), C reactive protein (CRP), fibrinogen (FIB), D-dimer and blood lipids, etc. were observed.

RESULTSAfter treatment, average number, total scores and area of plaque, as well as levels of CRP, FIB and D-dimer decreased significantly in the SBP group (P < 0.05 or P < 0.01), and were lower than those in the control group after treatment respectively (P < 0.05). No severe adverse reaction occurred in both groups.

CONCLUSIONSBP is a safe and effective remedy for treatment of CAS.

Adult ; Aged ; Aged, 80 and over ; Carotid Artery Diseases ; diagnostic imaging ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Tablets ; Treatment Outcome ; Ultrasonography

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Hepatitis B ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Young Adult

Objective To study the influences of Yang-warming, Blood-activating, and Toxin-removing Recipe(YBTR)-containing serum sampled under different conditions on the proliferation of human umbilical vein endothelial cells(HUVECs). Methods HUVECs were cultured in vitro for the experiment. Pharmacological serum for the experiment was prepared as follows: Thirty-two SD rats (male in half) were randomly divided into 4 groups, namely normal saline group and low-, middle-, and high-dose YBTR groups (at the intragastric dosage of 10.35, 31.05, 93.15 g·kg-1 respectively, twice a day). The pharmacological serum was taken from one female rat and one male rat in various groups at 4 time points, i.e. at hour 1, 2 after first intragastric administration on the fourth feeding day, and at hour 1, 2 after first intragastric administration on the sixth feeding day(abbreviated as D3H1, D3H2, D5H1, D5H2 respectively). The effects of YBTR-containing serum on the proliferation of HUVECs were observed by CCK-8 assay method. Results The difference of proliferation-inhibition rate of HUVECs was statistically significant after treated with YBTR-containing serum prepared from rats of different genders at different time(Pgender=0.000<0.01, Ptime=0.000<0.01). The difference of interaction of time and gender was also significant (Ptime × gender=0.001<0.01), and the effect at D3H1 and D5H1 varied with the gender (PD3H2×gender = 0.000 < 0.01, PD5H1×gender = 0.002 < 0.01). The inhibitory action of YBTR-containing serum became stronger with the increase of the dosage of serum of female rat at D3H2, and the inter-group difference was statistically significant (P < 0.05), the effect showing concentration-dependent tendency. The inhibition of HUVECs proliferation reached the peak after treated by various doses of YBTR-containing serum from the female rat at D3H2, while the inhibition arrived to the peak after treated by low- and middle-dose YBTR-containing serum from the male rat at D5H1, and the inhibition arrived to the peak in the group of high-dose YBTR-containing serum from the male rat at D3H1. Conclusion The inhibitory action of YBTR-containing serum on the proliferation of HUVECs was stronger when the serum was taken from the female rat at D3H2.

OBJECTIVE: To compare several noninvasive indices of fibrosis in chronic viral hepatitis B, including liver shear-wave velocity (SWV), hyaluronic acid (HA), collagen type IV (CIV), procollagen type III (PCIII), and laminin (LN). MATERIALS AND METHODS: Acoustic radiation force impulse (ARFI) was performed in 157 patients with chronic viral hepatitis B and in 30 healthy volunteers to measure hepatic SWV (m/s) in a prospective study. Serum markers were acquired on the morning of the same day of the ARFI evaluation. Receiver operating characteristic (ROC) analysis was performed to evaluate and compare the accuracies of SWV and serum markers using METAVIR scoring from liver biopsy as a reference standard. RESULTS: The most accurate test for diagnosing fibrosis F ≥ 1 was SWV with the area under the ROC curve (AUC) of 0.913, followed by LN (0.744), HA (0.701), CIV (0.690), and PCIII (0.524). The best test for diagnosing F ≥ 2 was SWV (AUC of 0.851), followed by CIV (0.671), HA (0.668), LN (0.562), and PCIII (0.550). The best test for diagnosing F ≥ 3 was SWV (0.854), followed by CIV (0.693), HA (0.675), PCIII (0.591), and LN (0.548). The best test for diagnosing F = 4 was SWV (0.965), followed by CIV (0.804), PCIII (0.752), HA (0.744), and LN (0.662). SWV combined with HA and CIV did not improve diagnostic accuracy (AUC = 0.931 for F ≥ 1, 0.863 for F ≥ 2, 0.855 for F ≥ 3, 0.960 for F = 4). CONCLUSION: The performance of SWV in diagnosing liver fibrosis is superior to that of serum markers. However, the combination of SWV, HA, and CIV does not increase the accuracy of diagnosing liver fibrosis and cirrhosis.
Acoustics ; Biological Markers ; Biopsy ; Collagen Type III ; Collagen Type IV ; Elasticity Imaging Techniques ; Fibrosis* ; Healthy Volunteers ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hyaluronic Acid ; Laminin ; Liver Cirrhosis ; Liver* ; Prospective Studies ; ROC Curve