Humans ; Liver Diseases, Alcoholic ; diagnosis ; etiology ; therapy

Humans ; Liver Cirrhosis ; diagnosis

BACKGROUND: Self-reported low back pain (LBP) has been evaluated in relation to material handling lifting tasks, but little research has focused on relating quantifiable stressors to LBP at the individual level. The National Institute for Occupational Safety and Health (NIOSH) Composite Lifting Index (CLI) has been used to quantify stressors for lifting tasks. A chemical exposure can be readily used as an exposure metric or stressor for chemical risk assessment (RA). Defining and quantifying lifting nonchemical stressors and related adverse responses is more difficult. Stressor–response models appropriate for CLI and LBP associations do not easily fit in common chemical RA modeling techniques (e.g., Benchmark Dose methods), so different approaches were tried. METHODS: This work used prospective data from 138 manufacturing workers to consider the linkage of the occupational stressor of material lifting to LBP. The final model used a Bayesian random threshold approach to estimate the probability of an increase in LBP as a threshold step function. RESULTS: Using maximal and mean CLI values, a significant increase in the probability of LBP for values above 1.5 was found. CONCLUSION: A risk of LBP associated with CLI values > 1.5 existed in this worker population. The relevance for other populations requires further study.
Bayes Theorem ; Benchmarking ; Lifting* ; Low Back Pain* ; Musculoskeletal Diseases ; National Institute for Occupational Safety and Health (U.S.) ; Occupational Exposure ; Prospective Studies ; Risk Assessment*

OBJECTIVETo investigate the ability of the model for end-stage liver disease (MELD) score combined with serum sodium measurements to effectively evaluate the prognosis of patients with decompensated liver cirrhosis.

METHODSA total of 212 patients with decompensated cirrhosis were retrospectively analyzed. Each patient's MELD scores, and sodium-based MELD scores (MELD-Na, MELDNa, and MESO) were calculated at three-month intervals. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the predictive abilities of the four scores for 3-, 6- and 12-month mortality. Kaplan-Meier survival curves were created using the best cut-off values for each score identified by the ROC.

RESULTSAmong the 212 patients, 46 died within three months, 56 died within six months, and 87 died within 12 months. The MELD, MELD-Na, MELDNa and MESO scores were significantly different between patients who survived and those who died within three and 12 months (P less than 0.01). The AUCs for the four separate scores were all more than 0.8 at the 3- and 6-month time points; however, the AUCs of MELDNa (3-month: 0.846; 6-month: 0.869) and MESO (0.831; 0.850) were significantly better than those of MELD (0.812; 0.841) (P less than 0.05). At the 12-month time point, the AUCs of MELD, MELD-Na, MELDNa, and MESO were not significantly different (0.774, 0.775, 0.786, and 0.777, respectively). Survival curves showed that all the scores were able to clearly discriminate the patients who survived from those who died within 12 months (P=0.000).

CONCLUSIONThe MELD score and its sodium-based variants (MELD-Na, MELDNa, and MESO) can precisely predict mortality of patients with decompensated cirrhosis for short and intermediate periods. The MELDNa and MESO scores are superior for predicting 3- and 6-month survival.

Adult ; Aged ; Aged, 80 and over ; End Stage Liver Disease ; blood ; mortality ; Female ; Humans ; Liver Cirrhosis ; blood ; mortality ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Sodium ; blood

Objective To investigate the efficiency and complications of stereotactic surgery combined with intra-operative electrocorticography (ECoG) and intra-operative neurophysiologic monitoring (IOM) in treating epilepsy secondary to subcortex small tumors in the functional areas.Methods Fifteen patients with epilepsy secondary to subcortex small tumors in the functional areas,admitted to our hospital from June 2006 to June 2011, were chosen in our study. Resection was performed to these tumors. Guiding with stereotaxic apparatus, epileptogenic foci and boundary localizing by intra-operative ECoG monitoring,functional areas and neuronal structures in the epileptic region judging by IOM,the epileptogenic foci were resected or performed multiple subpial wansaction (MST) and/or cortices lower output powers thermocoagulation.The treatment efficacy was concluded.Results Total resection was achieved in 13 patients and subtotal resection in 2.Epileptogenic foei were ablated in 4 patients,and peri-lesioned cortex of epileptogenic foci in other 11 patients were performed lower output powers thermocoagulation or/and MST. ECoG monitoring found epileptiform discharge disappearance in 6 patients,residual of a few spikes in 6,residual of a lot of spikes as well as having mild to moderate abnormal basilic rhythms in EEG in 3.No permanent and severe complications were noted.All patients were followed up for 1 to 3 y; tumor recurrence was noted in 2; according to Engel's classification standards,Engel I was noted in 10,Engel Ⅱin 3 and Engel Ⅲ in 2,and the effective rate was 100％. Conclusion Stereotactic surgery combined with intra-operative ECoG and IOM is a safe,effective and microinvasive management for epilepsy secondary to subcortex small tumor in the functional areas; it can accuratly locate and totally resect the tumors,treating the epileptogenic foci and avoiding functional defects.

Acetamides ; Aminopyrine ; Animals ; Breath Tests ; methods ; Carbon Isotopes ; Chemical and Drug Induced Liver Injury ; diagnosis ; pathology ; physiopathology ; Humans ; Liver ; injuries ; pathology ; physiopathology ; Liver Cirrhosis ; diagnosis ; pathology ; physiopathology ; Liver Diseases ; diagnosis ; pathology ; physiopathology ; Liver Function Tests ; Phenylalanine ; Prognosis

OBJECTIVETo evaluate the efficacy and safety of Capsule metadoxine in the treatment of alcoholic liver disease.

METHODSA randomized double blind multicenter placebo-controlled clinical study was performed to evaluate the therapeutic effectiveness and safety of capsule metadoxine. Patients in metadoxine group received capsule metadoxine 500mg tid po. Patients in placebo group received placebo 2 pillows tid po. The treatment duration was 6 weeks. Patients were followed up 2 weeks after the treatment. Patients were visited once every 3 weeks during the treatment period. Clinical symptoms and liver function were evaluated in all the patients before treatment, at week 3, week 6 and 2 weeks after therapy. CT scan was done in some patients before treatment and at the end point of therapy.

RESULTS254 patients were recruited in the study, 126 in metadoxine group and 128 in placebo group. Median ALT, AST, GGT level in metadoxine group were decreased from 80.0 U/L, 59.2 U/L, 123.0 U/L (before treatment) to 41.1 U/L, 36.0 U/L, 57.0 U/L (after 6 weeks therapy). The improvement in liver function was more significant in metadoxine group than in placebo group (P less than 0.05). For the patients who stopped drinking during the study, the total effective rate of improvement in liver function was 82.8% in metadoxine group, much higher than that in placebo group (55.7% , P=0.0000). For the patients who did not stop drinking during the study, the total effective rate of improvement in liver function was 65.4% in metadoxine group, which is not significantly higher than that in placebo group (44.8%, P=0.1767). The CT value ratio of liver to spleen was significantly improved in metadoxine group (P=0.0023), and there was no significant difference between the two groups (P=0.6293). The rate of adverse was 1.6% in both of groups.

CONCLUSIONCapsule metadoxine is an effective and safe treatment for alcoholic liver disease.

Administration, Oral ; Adult ; Aged ; Alanine Transaminase ; blood ; Alcohol Deterrents ; administration & dosage ; therapeutic use ; Analysis of Variance ; Aspartate Aminotransferases ; blood ; Capsules ; Double-Blind Method ; Drug Combinations ; Fatty Liver, Alcoholic ; blood ; drug therapy ; pathology ; Female ; Follow-Up Studies ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Diseases, Alcoholic ; blood ; drug therapy ; pathology ; Liver Function Tests ; Male ; Middle Aged ; Pyridoxine ; administration & dosage ; therapeutic use ; Pyrrolidonecarboxylic Acid ; administration & dosage ; therapeutic use ; Treatment Outcome ; Ultrasonography ; Young Adult ; gamma-Glutamyltransferase ; blood

OBJECTIVETo assess the efficacy and safety of Dengzhanxixin injection for unstable angina pectoris.

METHODAll clinical studies of Dengzhanxixin injection for unstable angina pectoris (UAP) were searched from Cochrane library, Medline, EM-base, CBM, CNKI, Wanfang and VIP. Quality assessment and information extraction were done by two independent screening . The quality of the included documents was evaluated by the Cochrane Collaboration's tool for assessing risk of bias and allocation concealment. Revman 5.1.4 software was used for data analysis.

RESULTA total of 17 randomized controlled trials were included (1 644 patients), in which, only 2 studies were true RCT, 1 study used single blind method, while other studies did not mention allocation concealment, blind and loss-up information. Meta-analysis showed that the Dengzhanxixin injection group was better than the conventional treatment group in efficiency (OR = 3.54, 95% CI [2.60-4.82]) and ECG (OR = 2.36, 95% CI[1.88-2.96]). Researches with ADR/AE information of Dengzhanxixin injection showed that the symptoms of ADR/AE were slight. This study may exist publication bias.

CONCLUSIONDengzhanxixin injection on the basis of conventional treatment can improve the efficacy of the treatment of unstable angina pectoris. However, due to the sample size of included studies were small and of lower quality, conclusions above still need high-qualitied randomized, double-blind, controlled trials be confirmed.

Adult ; Aged ; Aged, 80 and over ; Angina, Unstable ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic

OBJECTIVETo assess the efficacy and safety of Shenmai injection for acute myocardial infarction (AMI).

METHODAll clinical studies of Shenmai for AMI were searched from Cochrane library, Medline, EMbase, CBM, CNKI, Wanfang and VIP. For efficacy analysis of Shenmai, randomized controlled trials (RCTs) and quasi-RCTs were included and the Cochrane Collaboration's RevMan 5.1 was used for data analysis.

RESULT1) Fifty studies were included for efficacy analysis, in which, only 1 study was true RCT, all of studies did not mention allocation concealment, blind and information of loss to follow-up. The fatality rate during hospitalization (OR 0.43, 95% CI [0.31-0.60]), incidence of heart failure (OR 0.49, 95% CI [0.34-0.70]), incidence of shock (OR 0.53, 95% CI[0.30-0.93]) and incidence of re-infarction (OR 0.16, 95% CI [0.03-0.77]) in Shenmai injection plus conventional treatment group was lower than that in the conventional treatment group, while the rate of recanalization (OR 1.24, 95% CI [0.90-1.71]) was similar between the two groups. 2) For safety analysis, we did not found serious adverse drug reaction/adverse events (ADR/AE) of Shenmai injection for AMI.

CONCLUSIONThe currently available evidence showed that Shenmai injection plus conventional treatment group may decrease the fatality rate during hospitalization, the incidence of cardiac failure, shock and re-infarction. However, these findings should be carefully interpreted due to the low methodological quality and small sample size of trials. Although serious ADR/AE was did not report of Shenmai injection, the post-marketing safety evaluation is need to be performed.

Adolescent ; Adult ; Aged ; Child ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; mortality ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Young Adult

OBJECTIVETo study the predictive value of ALT, HBeAg and HBV DNA levels at baseline and HBV DNA levels at week 12 adefovir dipivoxil (ADV) treatment to the efficacy of it at week 52 in patients with HBeAg-positive chronic hepatitis B (CHB).

METHODSNinety-eight HBeAg-positive CHB patients with serum HBV DNA>or=1x10(6) copies/ml and ALT levels between 1.5 to 10 times of upper limits of normal (ULN) were enrolled in the study. Ten mg/d of ADV was administered for 52 weeks. Line serum samples were collected for measuring HBV DNA and HBV markers. The efficacy of the treatment at week 52 was evaluated in patients with different ALT, HBeAg and HBV DNA levels at baseline and HBV DNA levels at week 12 after treatment.

RESULTSAt week 52 of ADV treatment, the rates of HBV DNA<10(3) were 72.7%, 66.7% and 53.0% respectively in patients with ALT>5xULN, HBeAg350 s/co (30.2%, P<0.01) and HBV DNA>10(8) copies/ml (34.4%, P<0.05) at baseline. HBeAg seroconversion rates were 42.2% and 7.5% (P<0.01) in patients with HBeAg titer350 S/co at baseline. In patients with HBV DNA<10(3), 10(3)-10(5) and >10(5) copies/ml at week 12, the ratios of them with HBV DNA<10(3) less than 1000 copies/ml at week 52 were 82.6%, 57.1% and 17.5% and significant differences were found between these groups (P<0.05); HBeAg seroconversion rates were 52.2%, 25.7% and 5.0% (P<0.05); ALT normalization rates were 100%, 83% and 75%, significantly higher in patients with HBV DNA<10(3) copies/ml than those with HBV DNA>10(5) copies/ml (P<0.05) at week 12. HBV DNA and HBeAg seroconversion at week 52 correlated with HBV DNA levels at week 12 (r=0.6 and r=0.5 respectively, P<0.01).

CONCLUSIONSIn HBeAg-positive CHB patients treated with adefovir dipivoxil, HBV DNA levels at week 12 can be used to predict the efficacy at week 52. HBV DNA<10(3) copies/ml at week 12 predict a better treatment result at week 52.

Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Male ; Organophosphonates ; therapeutic use ; Predictive Value of Tests ; Treatment Outcome ; Young Adult