Objective To make individualized evidence-based treatment for patients with diabetic peripheral neuropathy. Methods Based on the clinical questions we raised, evidence was collected and critically assessed. Patients’ preferences was also taken into consideration in the decision-making treatment. Results 157 studies were retrieved and finally 15 randomized controlled trials, 14 systematic reviews and meta-analyses, and 1 clinical guidelines were considered eligible. The evidence indicated that the first step in management of patients with diabetic peripheral neuropathy should aim for stable and optimal glycemic control; there was no statistically significant difference between aldose reductase inhibitors and placebo in the treatment of diabetic polyneuropathy, the same to nerve growth factor; alpha-lipoic acid is superior to placebo in reducing symptoms of diabetic peripheral neuropathy; 5-hydroxytryptamine and norepinephrine uptake inhibitor, tricyclic antidepressants and anticonvulsants might alleviate the pain in patients with diabetic peripheral neuropathy; vitamin B and capsaicin cream are is effective and safe in the management of diabetic peripheral neuropathic pain. The individualized treatment plans were developed based on the available evidence. After 3 month of treatment, the blood sugar returned to normal and symptoms were alleviated. Conclusion The treatment efficacy in diabetic peripheral neuropathy has been improved by determining an individulized treatment plan according to evidence-based methods.
ObjectiveTo observe the clinical efficacy and safety of reteplase in prehospital thrombolysis for ST-segment elevation acute myocardial infarction. MethodsWe retrospectively analyzed the clinical data of 62 patients with acute ST-segment elevation myocardial infarction treated in our hospital between September 2010 and December 2012.They were randomly divided into two groups:the treatment group with 22 patients given reteplase thrombolysis therapy in the prehospital ambulance and/or emergency department,and the control group with 40 patients receiving thrombolytic therapy in the hospital.Then,we compared 60-minute and 120-minute recanalization rate,the rate of complicating with various kinds of adverse reactions and the composite end-point event rate between the two groups. ResultsSixty minutes and 120 minutes after thrombolysis,the clinical judgment recanalization rate in the treatment group was significantly higher than that in the control group (P<0.05).Four weeks after hospitalization,the rate of complicating with various kinds of hemorrhage,hypotension and death rate in the two groups had no statistical difference (P>0.05). ConclusionPrehospital thrombolysis treatment for ST-segment elevation acute myocardial infarction has a better clinical efficacy and is worth popularizing in basic unit hospitals.
Objective To provide an overview of the main anti-tumor mechanisms of attenuated Salmonella typhimurium（ST） and explore potential reasons for the limited clinical application of attenuated ST. Methods The literatures related to clinical and basic research on attenuated ST tumor treatment and virulence at home and abroad in recent years were reviewed and the relevant mechanisms of attenuated ST tumor treatment were summarized. And then, analyses were made regarding the failure of clinical application experiments of attenuated ST based on the characteristics of attenuated ST and the human immune microenvironment. Results Attenuated ST could inhibit the growth of primary tumors and reduce the metastasis of secondary tumor due to its effect of tumor-targeting, its property of facultative anaerobic and its characteristic of being able to carry plasmids. On the other hand, the toxicity of wild strains to hosts had been reduced through biotechnology. In terms of clinical application, the anti-tumor effect of attenuated ST was far lower than expected due to excessive detoxification of ST, the elimination effect of foreign substances by the human immune system, and the inactivation effect of various proteases in the body. Conclusion As an emerging bacterial mediated anti-tumor therapy, attenuated ST will provide a new treatment option for precise treatment of cancer patients once its clinical application problems are solved.
ObjectiveTo summarize the latest research of long non-coding RNA (lncRNA) as competitive endogenous RNA (ceRNA) and its targeting technology in pancreatic cancer, so as to provide new ideas for lncRNA targeted intervention or as an early diagnostic marker of pancreatic cancer. MethodThe domestic and foreign literature on researches of lncRNA as ceRNA and its targeting technology in the pancreatic cancer was searched and reviewed. ResultsAt present, the growing number of evidences showed that in pathological states such as tumors, the abundance of intracellular lncRNAs was sufficient to trigger ceRNA crosstalk. The lncRNA played a role like “sponge” through the complementary binding of incomplete base of miRNA with miRNA response elements, then adsorbed miRNA, and thus changed the activity and effectiveness of miRNA. It also regulated the expression of downstream target genes. Moreover, a large number of studies had identified that the lncRNA-mediated ceRNA regulatory network, namely lncRNA/miRNA/mRNA axis, played a role in promoting or inhibiting the occurrence and progression of pancreatic cancer through a variety of cellular functions. In addition, many technologies targeting lncRNA, such as small interfering RNA, antisense oligonucleotides, clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9, and small molecule inhibitors, etc. had been widely studied and acquired important results in preclinical research. ConclusionsThe ceRNA hypothesis is a functional complex composed by non-coding RNAs and mRNAs with non-coding properties, forming a ceRNA network of multi-level and cross-regulatory on the transcriptome. Epigenetic modification and key post-transcriptional regulation of lncRNA have been achieved through ceRNA network mechanism, which has become a successful paradigm for exploring the function of lncRNA. The tumor suppressive and promoting effects and mechanisms of many lncRNAs in the occurrence and development of pancreatic cancer are explored in many studies. Moreover, the continuous progress of targeted lncRNA technology provides conditions for study of lncRNA. LncRNA has a potential to be used as a biomarker for precancerous diagnosis and prognosis of pancreatic cancer.
ObjectiveTo summarize the biological function and molecular regulation mechanism of serine threonine tyrosine kinase 1 (STYK1) in tumor occurrence and development. MethodThe relevant literature about STYK1 and tumor progression in recent years was searched and reviewed. ResultsThe expression of STYK1 was up-regulated in a variety of tumors and was related to the prognosis. STYK1 might regulate the proliferation, apoptosis, migration, metastasis, aerobic glycolysis, drug resistance and other biological functions of tumor cells through MEK/ ERK, PI3K/AKT, JAK/STAT and their targeting proteins, and promote the malignant progress of tumors. Conclusion STYK1is expected to become a new target for the treatment of malignant tumors, but the molecular mechanism of its regulation of tumor progression and its upstream regulators need to be further explored.
【摘要】 目的 探讨B型超声对肺不张的诊断价值。 方法 对2007年5月-2009年5月收治的67例肺不张患者的CT诊断与B型超声诊断进行对照、分析、总结。 结果 B型超声诊断一侧肺不张和肺叶肺不张与CT诊断符合率为94.64%，肺段型肺不张诊断符合率为54.55%。 结论 B型超声诊断可作为肺不张筛查的首选诊断方法。【Abstract】 ObjectiveT o study the diagnostic value of atelectasis by type-B ultrasonography. Methods Data of 67 cases of patients with atelectasis diagnosed by type-B ultrasonography and CT were compared, analyzed, and summarized between May 2007 and May 2009. Results The diagnosis coincidence rate which was got by comparing ultrasonography diagnosis of the one side atelectasis and pulmonary lobectomy atelectasis with CT diagnosis was 94.64%, and that of pulmonary segmental atelectasis was 54.55%. Conclusion Type-B ultrasonography can be used as the preferred screening atelectasis diagnosis.
ObjectiveTo investigate the value of morning blood pressure surge in the evaluation of atherosclerosis by the observation of the relationship between morning blood pressure surge and ambulatory arterial stiffness index. MethodsFrom May 2011 to March 2013, we followed up 300 hypertensive patients who received ambulatory blood pressure monitoring, and they were divide into elevated morning blood pressure surge group and non-elevated morning blood pressure surge group. The AASI value was recorded and compared between the two groups according to the grade of hypertension. ResultsMorning blood pressure surge was more common in patients with hypertension. Compared with patients in the non-elevated morning blood pressure surge group, ambulatory arterial stiffness index was significantly higher in patients in the elevated morning blood pressure surge group. ConclusionThere is a certain correlation between morning blood pressure surge and arterial stiffness, which is an important factor leading to a variety of target organ damage.
Gastrointestinal (GI) complications after heart surgery included slight bleeding through fulminant hepatic failure. Although overall rate of these complications is low, it can lead to high mortality after heart surgery. Diagnosis of GI complication is difficult. Risk factors for GI complications are clear. Mechanisms of complications are various. Therefore, we collected the recent prospective and retrospective literatures to sumarize mortality of GI complications, pathogenesis, risk factors, recent progress of prevention and management, to guide clinical practice.
Objective To systematically review the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) and sorafenib (SORF) separately or combined in the treatment of advanced hepatocellular carcinoma (HCC). MethodsWe searched the PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases for studies on HAIC and SORA separately or in combination in the treatment of advanced HCC from inception to November 1, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 21 studies involving 2 501 patients were included. The results of meta-analysis showed that the overall survival (OS) (HR=0.46, 95% CI 0.25 to 0.87, P=0.02), objective response rate (ORR) (OR=4.00, 95%CI 2.74 to 5.85, P<0.000 01) and disease control rate (DCR) (OR=2.20, 95%CI 1.30 to 3.75, P=0.004) were higher in the HAIC group than the SORF group, while the incidence of adverse reactions was not increased. However, HAIC combined with SORF showed no significant difference in OS, ORR, DCR or progression-free survival (PFS) compared with SORF alone. Moreover, combined treatment increased the adverse reactions of blood system. Conclusion The current study suggests that HAIC can improve OS, ORR and DCR in patients with advanced HCC; however, there is no additional benefit when combining SORF with HAIC. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.