1.Clinical efficacy and safety of unilateral biportal endoscopy versus microendoscopic discectomy in treatment of lumbar spinal stenosis: a Meta-analysis
Shaojie HE ; Dingsheng ZHA ; Jiawen HUANG ; Zhenyu ZHAO ; Sheng TANG ; Xiaofeng LAI ; Hao WU
Chinese Journal of Orthopaedic Trauma 2022;24(7):634-639
Objective:To compare the efficacy and safety of unilateral biportal endoscopy (UBE) and microendoscopic discectomy (MED) in the treatment of lumbar spinal stenosis by Meta-analysis.Methods:PubMed, Web of Science, CNKI and Wanfang Data were searched from their establishment to January 2021 for all the studies on UBE and MED in the treatment of lumbar spinal stenosis. The data extracted were authors, year of publication, study design, subject characteristics, sample size, surgical protocol, age, sex ratio, duration of surgery, length of hospital stay, complications, visual analogue scale (VAS), and Oswestry Disability Index (ODI). The Meta-analysis was conducted with software Revman 5.3 to analyze the operation time, hospital stay, complication rate, waist and lower extremity VAS scores and ODI scores at preoperation, early postoperation and the last follow-up. The quality of the case-control studies included was evaluated using the Newcastle Ottawa Scale (NOS) while the methodological quality and risk of bias of the randomized controlled studies (RCT) included were evaluated using the Cochrane Bias Risk Assessment Tool.Results:Finally, 7 studies were included, 6 in English and one in Chinese. There were 2 RCTs and 5 case-control studies. There were 251 patients in the UBE group and 224 patients in the MED group. Compared with the MED group, the UBE group had a significantly shorter hospital stay ( MD=-2.28, 95% CI: -3.42 to -1.14, P<0.001), and a significantly lower VAS score for early postoperative low back pain ( MD=-0.80, 95% CI:-1.44 to -0.16, P=0.01). There were no significant differences between the 2 groups in operation time, complication rate, waist VAS scores at preoperation or the last follow-up, lower extremity VAS or ODI scores at preoperation, early postoperation or the last follow-up, or dural dilatation area ( P>0.05). Conclusions:In the treatment of lumbar spinal stenosis, compared with MED, UBE is superior in early relief of low back pain and hospital stay after operation, but shows no significant difference in long-term efficacy or safety.
2.Research on Traditional Chinese Medicine Healthy Life-style Guiding Principles Based on Delphi Indagate
Xinyan CHEN ; Meifang LIU ; Yuehong LAI ; Jia'en LIANG ; Hai LI ; Ziyi YE ; Jiancheng TAN ; Jiawen ZHANG ; Yupeng FAN ; Yanzhao LIN
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(9):1560-1566
Through the expert questionnaire (Delphi Indagate) to form Traditional Chinese Medicine (TCM) Healthy Lifestyle Guiding Principles.We conducted two rounds of surveys of TCM experts in the field of preventive health care on the basis of previous literature research.This study was aimed to form the framework in order to entry to the TCM Healthy Life-style Guiding Principles.The results showed that the positive coefficient of experts in two rounds of investigation were 84.31% and 100%,respectively.The authoritative decree were both more than 0.7.The expert opinion score mean median was 9.21 and 9.085.Median mean values were 7.965 and 7.925.The median scores of full marks were higher than 65.12% and 66.67%.The minimum coefficients of variation were 0.11 and 0.10.It was concluded that in the investigation and study,the enthusiasm of the experts,professional standards and credibility were high.Expert opinion is more concentrated.Expert opinion is well coordinated and gradually converges through two rounds of surveys.Through the Delphi indagate,the basic framework and items of TCM guiding principles of healthy lifestyle were established,which laid the foundation for further standardizing the guiding principles of TCM in healthy lifestyle.
3.Treatment of Liver Failure by Chinese Medicine Mediating Related Signaling Pathways: A Review
Jiawen LAI ; Lijing XU ; Yuanqian YAO ; Zhihao YE ; Wenfan LIU ; Jianlin LYU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):272-280
Liver failure (LF) is a great trouble to the majority of patients due to its severe onset, many complications, difficult treatment, poor prognosis and other characteristics. This disease is liver injury caused by infection, hepatotoxic substances, autoimmunity, circulation disorders and other factors. It is a group of common clinical symptoms mainly manifested by coagulation disorders, jaundice, hepatic encephalopathy, ascites, and so on. In traditional Chinese medicine, it falls under the categories of "tympanites", "jaundice" and other diseases. At present, the research progress of Western medicine in the treatment of LF is slow, and its clinical application effect is still not ideal. In contrast, traditional Chinese medicine has a long history in the treatment of this disease, with over thousands of years of clinical practice and verification. It is characterized by exact efficacy and fewer side effects. The pathological mechanism of LF is extremely complex, involves a variety of signaling pathways, and is mainly related to inflammation, oxidative stress, liver fibrosis, cell apoptosis and other processes. In recent years, many studies have shown that traditional Chinese medicine can intervene in the occurrence and development of LF by mediating relevant signaling pathways in vivo, but there is still a lack of relevant summary. Therefore, this review summarized several signaling pathways related to the intervention of traditional Chinese medicine in LF by referring to and sorting out relevant literature worldwide, including nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPK), phosphatidylin-ositol-3-kinase/protein kinase B (PI3K/Akt), transforming growth factor-β/ drosophila mothers against decapentaplegic proteins (TGF-β/Smads), and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1), and elaborated the specific mechanism of their intervention in LF. This paper aims to provide practical and effective pathways and corresponding mechanisms for the treatment of LF by traditional Chinese medicine, and to provide new ideas and a theoretical basis for the clinical treatment of LF and further scientific research.