It is a common phenomenon that medical research is out of line with clinical work at present. In fact, there is intrinsic interrelation between clinical work and research. Thinking and exploration at clinics are part of the research, and any research based on chnical work not only has great value, but also receives strong support from the state. However, to translate clinical research into clinical practice is difficult, which requires evidence-based methodology, a knowledgable team with persistence andtechnologies, et al.

OBJECTIVETo evaluate the efficacy and safety of the combination therapy of Xipayimaizipizi Capsules and Tamsulo- sin in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe randomly assigned 60 BPH patients to a control and a combination group of equal number, the former aged 62.03 ± 10.19 years with a disease course of 3.24 ± 2.18 years and the latter aged 64.77 ± 10.33 years with a disease course of 4.09 ± 2.63 years. We treated the patients in the control group with Tamsulosin at 0.2 mg qd and those in the combination group with Tamsulosin at 0.2 mg qd plus Xipayimaizipizi at 0.5 g tid, respectively, both for 4 weeks. Then, we obtained the mean frequency of nocturnal urination, maximal urinary flow rate (Qmax), residual urine volume, International Prostate Symptom Score (IPSS) , and quality of life scores (QOL) of the patients, and recorded their adverse reactions.

RESULTSBefore treatment, the nocturnal urination frequency, Qmax, IPSS, and QOL were 3.60 ± 1.81, (10.40 ± 3.53) ml/min, 22.47 ± 8.58, and 4.43 ± 1.50 in the control group, as compared with 3.43 ± 1.61, (10.14 ± 3.43) ml/min, 21.93 ± 8.79, and 4.73 ± 1.31 in the combination group. After 4 weeks of medication, the combination group showed more significant improvement than the control in the nocturnal urination frequency (1.30 ± 1.18 vs 2.27 ± 1.60), Qmax ([13.85 ± 3.15] vs [14.36 ± 3.03] ml/min), IPSS (13.00 ± 1.53 vs 17.20 ± 8.43), and QOL (2.57 ± 1.61 vs 2.93 ± 1.68), all significantly better than the baseline (P < 0.05). The combination therapy achieved remarkable improvement as compared with the control in the nocturnal urination frequency (- [2.13 ± 1.11] vs -[1.73 ± 1.07]), IPSS (- [8.93 ?6.01] vs -[4.80 ± 3.87]), and QOL (- [2.17 ± 1.12] vs -[1.50 ± 1.01]) (P < 0.05), but exhibited no significant differences from the latter in Qmax ([3.72 ± 2.281 vs [3.95 ± 2.53] ml/min) and residual urine volume (- [34.30 ± 37.43] vs - [26.43 ± 30.49] ml) (P > 0.05). Adverse reactions were found in 5 cases in the combination group (16.67%) and 3 cases in the control (10%) , with no remarkable differences between the two groups (P > 0.05).

CONCLUSIONThe combination therapy of Xipayimaizipizi Capsules and Tamsulosin can improve the symptoms of BPH and the patients quality of life of.

Aged ; Capsules ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; drug therapy ; Quality of Life ; Sulfonamides ; therapeutic use

OBJECTIVETo compare the clinical curative effects between 89Sr and its combination with the Guliu recipe (GLR, a Chinese herbal medicine) in treating multiple bone metastatic tumor of mammary cancer (MBM-MC).

METHODSBy adopting the random sampling and grouping method, 89Sr alone (Sr) and 89Sr combined with CHM (Sr-GLR) were used in treating 86 and 40 patients with MBM-MC respectively. The efficacy of therapy were appraised according to the degree of ostalgia relieving and quality of life (QOF) in patients, and the effect of treatment on focal bone metabolism and bone marrow hematopoietic function were compared.

RESULTSThe effective rate of Sr and Sr-GLR in relieving ostalgia was 83.72% and 95.00%, respectively (P > 0.05), the QOF improving and stabilizing rate of them 80.23% and 95.00% (P < 0.05), the effective rate on focal bone metabolism 59.30% and 52.50% (P > 0.05) and their hemo-toxicity 28.00% and 30.00% (P > 0.05).

CONCLUSIONSr-GLR is a combination therapy in treating MBM-MC with good effect, it could raise the patient's QOF, enhance the ostalgia relieving effect without increasing the hemo-toxicity of treatment.

Adult ; Aged ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; Breast Neoplasms ; drug therapy ; pathology ; radiotherapy ; Carcinoma, Ductal, Breast ; drug therapy ; radiotherapy ; secondary ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Quality of Life ; Strontium Radioisotopes ; therapeutic use

Objective To investigate the effect and significance of microglia/macrophage activation prior to cerebral ischemic preconditioning (CIP) in regulating toll-like receptors 2 (TLR2)/nuclear factor-kappa B (NF-κB) inflammatory signaling pathway in early stage after ischemic brain injury in rats.Methods Thirty healthy male SD rats were selected and divided into normal control group,sham operation group,ischemia group,intervention group and treatment group according to random number table,with six rats per group.A rat model of focal permanent cerebral infarct was established by occlusion of middle cerebral artery (MCAO).CIP was performed by local ischemia-reperfusion.Minocycline was used to inhibit microglia/macrophage activation after CIP.Features of microglia/macrophage activation after CIP were detected by immunofluorescence; mRNA expressions of predominant factors (NF-κB inhibitor α,IκB-α;tumor necrosis factor α,TNF-α) of TLR2/NF-κB inflammatory signaling pathway in parietal cerebral cortex by in situ hybridization method; death rate by Kaplan-meier survival curves; neurological deficits by a 5-point neurological scale; brain infarct size by triphenyl tetrazolium chloride (TTC) staining.Results Microglia/macrophage started activation at one hour after cerebral ischemic injury in preconditioning group and presented a significant increase at 12 hours.Speed and range of activation were higher in preconditioning group than in ischemic group.IκB-α mRNA in preconditioning group started expression at one hour.TNF-α mRNA in preconditioning group remained a low expression in 12 hours and had a significantly lower peak value as compared with that in ischemic group (P ＜ 0.05).CIP increased rat survival rate significantly,improved nerve function and reduced infarction size when compared with the ischemia group (P ＜ 0.05).Minocycline inhibited nerve protection by CIP significantly (P ＜0.05).Conclusion CIP induces rapid activation of microglia/macrophage in early period of rat cerebral ischemic injury and provides brain protection probably via inhibition of TLR2/NF-κB activity and inflammatory overreaction to cerebral ischemia.

Adenocarcinoma ; pathology ; Adenocarcinoma, Papillary ; pathology ; Aged, 80 and over ; Carcinoma, Renal Cell ; pathology ; Duodenal Neoplasms ; pathology ; Humans ; Kidney Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Neoplasms, Multiple Primary ; pathology ; Sarcoma ; pathology ; Stomach Neoplasms ; pathology

Objective To improve the safety of surgery,the application of indocyanine green fluorescein(ICG)angiography in intracranial aneurysm surgery was investigated.Methods Fifty cases of intracranial aneurysms were retrospectively analyzed.All the patients were received ICG angiography before and after intracranial aneurysm clipping.The efficiency of the surgery was evalu-ated with CT angiography(CTA)and(or)digital subtraction angiography(DSA).The postoperative follow-up was conducted using Glasow outcomes score(GOS).Results Of the 50 patients,3 cases of aneurysmal neck remnant,one case of parent arteries steno-sis,one case of nearby branch stenosis and two cases of “false-negative”were observed after ICG angiography.The clips were adjus-ted until the satisfactory blood flew was restored.Postoperative CTA and(or)DSA confirmed the results of intraoperative ICG an-giography.Of the 40 patients underwent follow-up,GOS score was 5 in 30 cases,4 in 7 case,3 in 2 case and 2 in 1 case.Conclusion ICG angiography is a useful way to assess the clipping of aneurysms,blood flew of parent arteries and nearby branches during the aneurysm surgery.It could raise the safety of surgery and further improve the clinical outcomes of intracranial aneurysms.

Objective To introduce the experience and analyze the clinical outcome of applica- tion of reinforced bar-ring hybrid external fixator combined with limited internal fixation for complex frac- turcs of tibia plateau in patients.Methods From Aug.2002 to Feb.2005,21 patients with complex fractures of tibial plateau were treated with reinforced bar-ring hybrid external fixatar combined with lim- ited internal fixation.According to Schatzker classification,there were 13 patients with typeⅤfracture and 8 with typeⅥfracture.Voluntary and non-weight beating knee joint motion to partially weight bear- ing was taken one week after operation.Progressive loading was taken continuously until there was clinical evidence of fracture stability and then full weight bearing was done.Results The mean follow-up peri- od was 15.9 months (10-24 months).All the fractures got united and the mean union time was 4.2 months(3-8 months).All the injured knees could extend to less than 5 degrees and flex to more than 90 degrees after rehabilitation.Evaluated by Merchant score system for knee joint,81% of patients achieved excellent healing (7 cases) and good healing (10 cases).Conclusion Operation by using reinforced bar-ring hybrid external fixator combined with limited internal fixation can reduce complications and avoid stiffness of the knee joint.It is an effective method for complex fractures of tibial plateau.

Objective To investigate the effect of total flavonoids of Herba Epimodii (HEF) on the expression of core binding factor?1 (Cbfal) in the bone of ovariectomized rats.Methods Fifty-four female SD rats were allocated into 6 groups (9 in each): sham operation group,ovariectomized (OVX) group,OVX followed by three kinds of HEF doses(40,80 and 160 mg?kg~(-1)?d~(-1))and nilestriol (0.1 mg?kg~(-1)?week~(-1))for 12 weeks respectively.Bone mineral density (BMD) of whole body was determined by DEXA.The levels of osteocalcin (BGP) and estradiol (E_2) in serum were measured by radioimmunologic method.All rats were then sacrificed,and total RNA were directly isolated from the skull.Relative quantification of Cbfal mRNA expression was detected by real time quantitative PCR.Results Serum E_2 and BMD of whole body in the OVX group were lower than those in sham group significantly after 12 weeks (both P0.05).Relative quantification of Cbfal mRNA expression in the OVX group was significantly lower than that in sham group after 12 weeks (P

Objective To model the newborn hypoxic-ischemic brain damage in rats. Methods 25 7-day-old healthy Wistar rats were divided into control group (n=12) and model group (n=13). 2 h after ligating and mutilating the unilateral common carotid arteries, the rats in the model group were put into an airtighted box with the volume fraction of 8% oxygen and 92% nitrogen for 2 h. 4 weeks after operation, all the rats were assessed behaviorally and pathologically. Results The footprint repeat space of rats were larger and more instable in the model group than in the control group (P<0.05). The time the rats crossing the balance beam was longer in the model group than in the control group (P<0.05). The escape latency of the water maze test was longer in the model group than in the control group (P<0.05). The right brain became smaller than the contralateral. HE staining showed that the cells around impaired periventricle were swelling, and cell number was less than the contralateral. The neurons decreased, some degenerated and necrosis neurocytes appeared in the impaired side. Conclusion The model of hypoxic-ischemic brain damage has been established.

OBJECTIVE: To investigate the position change of the fibular bone after maxillary reconstruction by free fibular flap and to analyze the factors affecting the position change. METHODS: Patients who underwent maxillary reconstruction by free fibular flap in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from November 2012 to November 2016 were enrolled in this study. CT scans 1 week and 1 year postoperatively were collected and stored in DICOM format. The ProPlan CMF software was used to reconstruct the CT scans and separate the maxilla and each segment of the fibular flap. The Geomagic Control software was used to measure the long axis direction vector of each fibular segment. And the position change direction was recorded. The patients were divided into groups according to the use of the fibula or titanium plate to reconstruct the zygomaticmaxillary buttress. RESULTS: A total of 32 patients were enrolled. Among them, 21 were in the titanium plate group and 11 in the fibula bone group. The angle between the long axis of the fibular segment and the X axis in the X-Y plane was 95.65°±53.49° and 95.53°±52.77°, 1 week and 1 year postoperatively, and there was no statistical difference (P>0.05). The angle between the long axis of the fibular segment and the X axis in the X-Z plane was 96.88°±69.76° and 95.33°±67.42°, respectively, with statistical difference (P=0.0497). The angular changes of the long axis of the fibular segment in the titanium plate group and the fibular bone group were 3.23°±3.93° and 1.94°±1.78°, respectively, and the angular changes in the X-Z plane were 6.02°±9.89° and 3.27°±2.31°, respectively. There was no significant difference between the groups (P>0.05). The long axis changes of the fibular segment in the X-Y plane for reconstruction of the anterior alveolar, posterior alveolar, and buttress were 3.13°±3.78°, 2.56°±3.17°, and 5.51°±4.39°, respectively. There was a statistical difference (P = 0.023) between the posterior and buttress. In the X-Z plane, theses were 4.94°±4.75°, 5.26°±10.25°, 6.69°±6.52°, respectively. There was no statistical difference among the three groups (P>0.05). The main positional deviation directions of the titanium plate group and the fibular bone group were interior and superior sides, and there was no statistical difference between the two groups (P>0.05). CONCLUSION One year postoperatively, the position of the free fibular flap was changed compared with 1 week postoperatively. The position of the free fibular flap was mainly changed to the interior and superior sides.
Bone Transplantation ; Fibula/diagnostic imaging* ; Free Tissue Flaps ; Humans ; Mandibular Reconstruction ; Maxilla/surgery*