Objective To assess reduction of adverse drug reaction incidence in patients with colorectal cancer receiving Jianpi herbs combined with chemotherapy. Methods The randomized controlled trials (RCTs) comparing Jianpi herbs combined with chemotherapy were searched through CBMdisc, CJFD, Wangfang Data and PubMed. The search was updated to September 2007. Software RevMan5, provided by Cochrane Library, was used to perform meta-analysis. Results Six RCTs were identified in this systematic review. All the methodology quality of the enrolled RCTs was gaded C. The pooled analysis showed that Jianpi herbs combined chemotherapy significantly reduced the incidences of grade I and grade II leucopenia [grade I with RR= 0.50 and 95%CI (0.31 to 0.80); grade II with RR= 0.37 and 95%CI (0.21 to 0.66)], grade II nausea and vomiting [RR= 0.51, 95%CI (0.31 to 0.84)] compared with routine chemotherapy. There was no statistical difference in reduction of neurotoxicity between the two groups. Conclusion The methodological quality of the RCTs using Jianpi herbs combined with chemotherapy on treating colorectal cancer should be improved. Based on this systematic review, Jianpi herbs combined with chemotherapy may reduce the incidence of mild to moderate adverse drug reaction, such as leucopenia and nausea and vomiting, in patients with colorectal cancer. Well-designed RCTs are needed in the future.
Sleep deprivation can cause hyperalgesia, and the mechanisms involve glutamic acid, dopamine, serotonin, metabotropic glutamate receptor subtype 5, adenosine A2A receptor, nicotinic acetylcholine receptor, opioid receptor, brain-derived neurotrophic factor, melatonin, etc. The mechanisms of hyperalgesia caused by sleep deprivation are complex. The current treatment methods are mainly to improve sleep and relieve pain. This paper reviews the mechanism and treatment progress of hyperalgesia induced by sleep deprivation, and aims to provide scientific evidence for the treatment of hyperalgesia caused by sleep deprivation.
ObjectiveTo summarize functions and mechanisms of poly ADP-ribose polymerase (PARP) inhibitors and its application in germline BRCA mutated breast cancer.MethodThe literatures about the PARP inhibitors and their applications in the treatment of germline BRCA mutated breast cancer at home and abroad in recent years were collected to make a review.ResultsAs a DNA repair enzyme, the PARP played an important role in the DNA repair pathway. Based on this mechanism, the PARP inhibitors had been developed and widely used in the clinic. On the other hand, the previous studies had shown that the PARP inhibitors marked the synthetic lethal effect in the cancers with homologous recombination deficiency mechanism. By inhibiting the PARP activity in the tumor cells with BRCA mutation, all the DNA damage repair pathways were blocked, which could induce the cell apoptosis or increase the sensitivity of tumor cells to chemoradiotherapy, resulting in the cell death.ConclusionIn patients with germline BRCA mutated breast cancer, PARP inhibitors can selectively kill breast cancer cells and show a high potential for individualized treatment.
Objective To summarize the latest research progress on the relationship between cN0 multifocal papillary thyroid microcarcinoma (PTMC) and central lymph node metastasis (CLNM) at home and abroad, so as to provide a reference for surgeons to balance the benefits and risks of surgery and select the best treatment plan. Method The latest studies on the relationship between CLNM and tumor characteristics of cN0 multifocal PTMC (including number of tumor foci, total tumor diameter, primary tumor diameter, total tumor surface area, etc.) were reviewed. Results Current domestic and international guidelines differ on whether cN0 PTMC should be used to prevent central lymph node dissection (pCLND). Proponents believe that pCLND could reduce the recurrence rate of disease and facilitate postoperative risk stratification and management under the premise of technical support. Opponents argue that it was not clear whether pCLND actually improves the prognosis of PTMC patients, but postoperative complications do correlate with pCLND. In order to guide the application of pCLND in the surgical treatment of cN0 PTMC, a large number of studies had reported the risk factors of CLNM in PTMC in recent years, among which multifocal was considered to be a very important risk factor for CLNM. In order to further understand the internal relationship between multifocal PTMC and CLNM, scholars at home and abroad quantified the feature of multifocal PTMC into various parameters, and studied the relationship between them and CLNM in multiple dimensions. It was found that total tumor diameter >1 cm, increased tumor number, total tumor surface area >3.14 cm2, diameter ratio <0.56, tumor volume >90 mm3 and bilateral multifocal PTMC might be the risk factors for increased CLNM risk in patients with cN0 multifocal PTMC. Conclusion These screened parameters are initially considered to be effective tools for predicting the risk of CLNM in multifocal PTMC. Multiple risk parameters coexist, especially in patients with multifocal PTMC characterized by bilateral intralar multifocal PTMC, who are expected to benefit more from pCLND. However, a large number of clinical studies are still needed to provide reliable evidence-based evidence for clinical diagnosis and treatment. In the future, by combining these valuable parameters, a scoring system can be constructed to predict the disease status of multifocal PTMC more accurately and identify patients with necessary pCLND, which will be of great significance for the appropriate treatment of PTMC.
ObjectiveTo develop altering intake managing symptoms (AIMS) dietary intervention and evaluate its effects on nutritional status and dietary compliance for patients after gastrectomy.MethodsFrom April 2017 to July 2018, 176 patients underwent the gastrectomy in the Xijing Hospital of Air Force Military Medical University were selected, then were divided into an AIMS group and a control group by the Excel 2007 random function method. The AIMS group was intervened by the AIMS dietary intervention, the control group was given the routine diet management. The body mass, body mass index (BMI), albumin, and dietary intake at the admission, on the 2nd week and the 3rd month after the discharge were compared between the two groups. The nutritional status of the two groups was assessed by the PG-SGA scale. The diet-related symptoms and dietary compliance of the two groups were assessed by the dietary related symptoms scale and the dietary compliance scale.ResultsA total of 176 eligible patients were enrolled in this study, including 92 patients in the AIMS group and 84 patients in the control group. There were no significant differences in the baseline data such as the gender, age, educational level, occupation, disease type, surgical method, tumor TNM stage, and pathological differentiated type between the two groups (P>0.050). There were no significant differences in the body mass, BMI, and albumin between the AIMS group and the control group before and after the dietary intervention (P>0.050). The PG-SGA score, diet-related symptom score, and dietary compliance score had significant differences between on the 2nd week or the 3rd month after the discharge and at the admission in the AIMS group and the control group (P<0.050), which had significant differences on the 2nd week or the 3rd month after the discharge between the AIMS group and the control group (P<0.001). The dietary intake of the AIMS group was significantly higher than that of the control group on the 3rd month after the discharge (P<0.001). The complications incidences of total diet-related symptoms was 5.5% (5/91) and 14.6% (12/82) in the AIMS group and the control group, respectively, the difference was statistically significant (P=0.047).ConclusionUsing AIMS dietary intervention for patients after radical gastrectomy can significantly improve their overall nutritional status and improve dietary compliance.
Objective To evaluate the effect of PNS on Idiopathic facial palsy. Methods A total of 86 cases of acute idiopathic facial paralysis were randomly divided into the treatment group (PNS group, 44 cases), and the control group (42 cases). The basis of the two groups included hormone therapy, B vitamins, anti-viral treatment, as well as acupuncture and physical therapy, both in the incidence of 7 days to give the treatment. House-Brackmann facial nerve function classification and evaluation were used to determine clinical efficacy; ENoG line was tested before and after treatment. Results Before H-B classification of facial nerve function, EnoG side of the latency and amplitude in the two groups were comparable. At 28 days after treatment, H-B scores for the treatment group and the control group were (2.33 ± 1.21) and (3.08 ± 1.35), respectively, and the two groups had significant differences (Plt;0.05); ENoG incubation period (2.46 ± 0.34) and amplitude (189 ± 67) of the treatment group were more than those of the control group; the incubation period (3.37 ± 0.49) and amplitude (131 ± 52) improved, and there were significant differences between the two groups (Plt;0.05). Comparison of efficacy of the two groups showed the total effective rate: 95.45% in the treatment group, 80.95% in the control group, and the efficacy of the treatment group was better than that of the control group (Plt;0.05). Conclusion Sanqi tongshu, B vitamins, anti-virus, such as the acupuncture and physical therapy for the treatment of acute idiopathic facial paralysis have significant effect.