目的 评价盐酸氨基葡萄糖治疗膝骨关节炎的疗效。 方法 将2012年1月－5月收治的150例膝骨关节炎患者随机分为A、B、C组。A组给予盐酸氨基葡萄糖治疗，B组给予碳酸钙D3片治疗，C组给予盐酸氨基葡萄糖联合碳酸钙D3片治疗，疗程8周。3组患者膝关节疼痛发作时服用塞来昔布并记录用量。比较试验前后3组患者骨关节炎指数评分（WOMAC）以及第1、8周塞来昔布用量变化情况。 结果 3组患者WOMAC总分、疼痛程度评分、关节僵硬程度评分、日常活动困难程度评分改善值比较，差异均无统计学意义。经过8周治疗，塞来昔布每周用量减少值A、B、C组分别为（0.41 ± 0.17）、（0.16 ± 0.22）、（0.46 ± 0.19）g，A、C组高于B组（P＜0.01），A、C组每周用量减少值差异无统计学意义（P＞0.05）。 结论 短期使用盐酸氨基葡萄糖治疗膝骨关节炎，在关节疼痛、僵硬及功能改善方面并不优于碳酸钙D3片，但可通过减少非甾体抗炎药物用量，使患者获益。
ObjectiveTo analyze the correlation of thrombopoietin (TPO) and anti-TPO antibody with thrombocytopenia in patients with primary Sjögren syndrome (PSS). MethodsWe included in our study 40 PSS patients with thrombocytopenia (group A), 22 PSS patients who once had thrombocytopenia and returned to normal (group B), 40 PSS patients with normal platelet counts (group C) and 40 healthy controls (group D) between September 2013 and October 2014. Anti-TPO antibody was detected by indirect enzyme-linked immunosorbent assay (ELISA), and serum TPO levels were measured by ELISA. We analyzed the relationship between the assay results and the clinical manifestations and parameters. ResultsThe serum TPO levels in groups A, B, and C were (129.74±17.47) , (330.23±18.07) and (364.19±12.25) pg/mL, respectively, and they were significantly higher than that in group D [(54.04±10.71) pg/mL] (P ＜ 0.05) . The serum level of TPO was positively correlated with CRP and IgA (rs=0.224, P=0.039; rs=0.239, P=0.033) , and was negatively correlated with C4 level (rs=?0.220, P=0.041) , but it was not significantly correlated with platelet count, erythrocyte sedimentation rate, the level of antiphospholipid antibodies and the titer of antinuclear antibodies (P ＞ 0.05) . The positive rate of PSS patients was 20.59% (21/102) and the rate in groups A, B, and C was respectively 17.5% (7/40) , 22.72% (5/22) , and 22.5% (9/40) . There was no statistically significant difference between the positive and negative groups in various clinical indexes (P ＞ 0.05) . ConclusionAntiTPO antibody may not be the main mechanism of thrombocytopenia in PSS patients, and there is a certain correlation between TPO and inflammatory factors.
ObjectiveTo systematically review the value of human epididymis protein 4 (HE4) in early diagnosis of endometrial cancer. MethodsDatabases including The Cochrane Library (Issue 1, 2013), PubMed, MEDLINE (Ovid), CNKI, CBM and WanFang Data were electronically searched for relevant studies on HE4 versus the golden standard (pathological examination) in the diagnosis of endometrial cancer from inception to April 2013. Meanwhile, relevant journals were also manually searched. Two reviewers independently screened literature according to the inclusion and exclusion criteria, and evaluated the included studies using the QUADAS items. Then, meta-analysis was performed using RevMan 5.1 and Meta-DiSc 1.0. ResultsFinally, a total of 16 studies involving 2 299 women (1 088 endometrial cancer patients diagnosed according to the golden standard, of which, 504 with benign uterine disease and 707 with normal cervical) were included. The results of meta-analysis showed that, as for HE4 in early diagnosis of endometrial cancer (SEN=57%, 95%CI 0.54 to 0.60; SPE=92%, 95%CI 0.91 to 0.94; +LR=6.92, 95%CI 5.00 to 9.58;-LR=0.46, 95%CI 0.39 to 0.55; DOR=18.38, 95%CI 12.21 to 27.69; AUC=0.881 7). ConclusionThe current study indicates that serum HE4 is more sensitive and low specific when applied in patients with endometrial cancer, which is worth of being used in clinic. Due to the limitation of low quality of the included studies, more high quality trials are required to verify the above conclusion.
Objective To make an individulized treatment plan for a patient with locally advanced non-small cell lung cancer (NSCLC). Methods After clinical problems were put forward, evidence was collected from http://www. nccn.org. The Cochrane Library (Issue 4, 2008), Medline (PubMed 1990. 1-2008.11) and CHKD periodical database were searched. Results A total of 21 RCTs, 5 systematic reviews and 13 CT phase Ⅲ trials were identified. A rational treatment plan was made upon a serious evaluation of the data. After nine monthes of follow-up, the plan was proved optimal. Conclusion For locally advanced NSCLC patients, an individulized treatment plan made by evidence-based methods not only can inprove the treatment efficacy but also can lead both of doctors and patients to assume the indeterminateness of medicine.
ObjectiveTo study the short-term efficacy and safety of tocilizumab in treating patients with active and resistant rheumatoid arthritis (RRA). MethodForty patients with RRA treated with tocilizumab between October 2013 and October 2014 were included in our study. The combined drug treatment was continued with the addition of tocilizumab 8 mg/kg per four weeks. The clinical responses and laboratory parameters were evaluated at the baseline, week 1, 4, 12, 16 and 24, and week 4 and 8 of tocilizumab withdrawal. ResultsTocilizumab was effective for several clinical lesions and laboratorial parameters at all time points. With the extension of treatment, the effect was better. At week 1, the visual analogue scale score of pain by patients, erythrocyte sedimentation rate, C-reactive protein (CRP), disease activity score 28 (DAS28) and health assessment questionnaire (HAQ) results decreased significantly (P<0.05). At week 12, the inflammatory biomarkers of all patients were normal, and 62.9% (22/35) of the patients achieved American College of Rheumatology (ACR)20, and 28.6% (10/35) of the patients achieved ACR50. At week 24, twelve patients achieved ACR50 and low activity (DAS28 score≤3.2), and the score of HAQ was minimum (3.1±1.6). The score of HAQ was significantly different between week 24 and the baseline (20.2±6.7) (P<0.01). All parameters were not significantly changed at week 4 of tocilizumab withdrawal compared with those before the withdrawal. Most parameters increased significantly at week 8 of tocilizumab withdrawal compared with week 4 of withdrawal (P<0.01) except for swollen joints, CRP, DAS28 and HAQ. The main adverse reactions were abnormal hepatic function and dyslipidemia followed by leukopenia. Only one patient stopped treatment because of adverse reaction. ConclusionsTocilizumab has rapid efficacy onset and good safety. After tocilizumab withdrawal, the efficacy can be maintained for 4 to 8 weeks.
ObjectiveTo summarize our clinical experience of bidirectional Glenn procedure (BGP) for the treatment of complex cyanotic congenital heart disease (CHD). MethodsClinical data of 68 patients with complex cyanotic CHD who underwent BGP in People's General Hospital of Xinjiang Uygur Autonomous Region from January 2007 to December 2012 were retrospectively analyzed. There were 40 male and 28 female patients with their average age of 3.9 years (range, 3 months to 22 years) and body weight of 6.2-53.0 (13.6±8.5)kg. Preoperative diagnosis included tricuspid atresia in 20 patients, single ventricle (SV) in 11 patients, double outlet right ventricle in 10 patients, complete transposition of great arteries in 7 patients, tricuspid stenosis in 5 patients, pulmonary atresia in 5 patients, corrected transposition of great arteries in 4 patients, tetralogy of Fallot in 4 patients and Ebstein's anomaly in 2 patients. Among them, there were 14 patients with dextrocardia or dextroversion of the heart, 2 patients with SV and pulmonary hypertension after pulmonary artery banding, and 1 complete transposition of great arteries patient after aortopulmonary shunt. Twenty-three patients received BGP under cardiopulmonary bypass (CPB) and 45 patients received BGP without CPB. ResultsTwo patients died postoperatively, including 1 patient with severe low cardiac output syndrome (LCOS) and another patient with pulmonary infection. Postoperative pulse oximetry oxyhemoglobin saturation (SpO2, 89.3%±7.4%) was significantly higher than preoperative SpO2 (66.8%±11.8%, P < 0.05). In 53 patients, postoperative SpO2 was more than 10% higher than preopera-tive SpO2. Postoperative hematocrit (0.40±0.07) was significantly lower than preoperative hematocrit (0.49±0.11, P < 0.05). Postoperative complications included pleural effusion in 16 patients (23.5%), chylothorax in 7 patients (10.3%), LCOS in 5 patients (7.4%), arrhythmias in 4 patients (5.9%), and pneumothorax in 1 patient (1.5%), who were all cured after appropriate treatment. Fifty-five patients were followed up for 9 months to 6 years after discharge with satisfactory clinical results. All anastomoses remained patent without stenosis or thrombosis. Four patients successfully received total cavopulmonary connection 2 to 5 years after discharge. ConclusionBGP is safe and reliable for patients with complex cyanotic CHD who cannot undergo anatomic correlation or one-stage repair.
ObjectiveTo systematically review the correlation between the expression of survivin and cervical cancer and its clinical pathologic features. MethodsSystematic and comprehensive literature was searched in The Cochrane Library (Issue 1, 2013), PubMed, MEDLINE (Ovid), CNKI, CBM and WanFang Data from inception to May 2013, to retrieve case-control studies published in the foreign and domestic areas on the correlation between the expression of survivin and cervical cancer and its clinical pathologic features. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the included studies. Then meta-analysis was conducted using RevMan 5.1 software. ResultsA total of 13 studies involving 1 530 women (658 cervical cancer patients, 563 cervical intraepithelial neoplasis (CIN), 658 normal cervical. The results of meta-analysis showed that, a) as for the positive rate of survivin expression, significant differences were found between cervical cancer and CIN (OR=4.63, 95%CI 3.49 to 6.13, P < 0.000 01), cervical cancer and normal cervical tissues (OR=38.23, 95%CI 23.92 to 61.11, P < 0.000 01), and CIN and normal cervical tissues (OR=9.61, 95%CI 6.11 to 15.09, P < 0.000 01). b) Significant differences were found between clinical stages Ⅰ-Ⅱ and clinical stages Ⅲ-Ⅳ (OR=0.17, 95%CI 0.07 to 0.41, P < 0.000 1), cervical cancer with lymph node metastasis and that without lymph node metastasis (OR=3.57, 95%CI 2.20 to 5.78, P < 0.000 01), high and moderate/low differentiated ESCC tissues (OR=0.31, 95%CI 0.13 to 0.76, P=0.01), and shallow and deep muscular infiltration (OR=0.12, 95%CI 0.02 to 0.68, P=0.02). No significant difference was found between cervical cancer with laterouterus or haemal infiltration and that without latero-uterus or haemal infiltration (OR=24.15, 95%CI 0.07 to 8 199.76, P=0.28). ConclusionCurrent foreign and domestic evidence shows that, survivin expression is significantly correlated to cervical cancer and its clinically pathologic features, which may participate in the whole course of carcinogenesis of cervical cancer, but it is not considered to be an absolute factor for estimating the survival rate of patients with cervical cancer. Due to the quality limitation of the included studies, more large scale, well-designed and high quality studies are needed for further verifying the aforementioned conclusion.
ObjectiveTo systematically review the correlation between Beclin1 protein expression and cervical cancer as well as its different clinical pathologic features. MethodsWe electronically searched databases including The Cochrane Library (Issue 1, 2014), PubMed, EMbase, Ovid, CNKI, VIP, CBM and WanFang Data from inception to February 2014, to collect the correlation between Beclin1 protein expression and cervical cancer as well as its different clinical pathologic features. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then meta-analysis was conducted using RevMan 5.2 software. ResultsA total of 5 case-control studies involving 637 patients were included, of which, 388 cases in the cervical cancer group, 130 cases in the cervical intraepithelial neoplasia (CIN) group, and 119 cases in the normal cervical tissue group. The results of meta-analysis showed that, a) as for Beclin1 expression, significant differences were found in cervical cancer vs. normal cervical tissues (OR=0.07, 95%CI 0.02 to 0.25, P < 0.000 1), cervical cancer vs. CIN (OR=0.37, 95%CI 0.23 to 0.59, P < 0.000 1), CIN vs. normal cervical tissues (OR=0.23, 95%CI 0.06 to 0.88, P=0.03), and cervical cancer tissues with vs. without lymph node metastasis (OR=0.29, 95%CI 0.17 to 0.49, P < 0.000 01). However, no significant difference was found in medium/low differentiation vs. well differentiation (OR=0.50, 95%CI 0.16 to 1.56, P=0.23), tumour diameter no less than vs. less than 4 cm (OR=0.72, 95%CI 0.44 to 1.18, P=0.20), myometrial invasion depth no less than vs. less than 1/2, and FIGO Ⅰ vs. Ⅱ (OR=0.70, 95%CI 0.44 to 1.10, P=0.12). ConclusionBeclin1 protein expression is notably associated to cervical cancer. Due to the limited quantity and quality of the included studies, the above conclusion still needs to be further verified by performing more high quality studies.
ObjectiveTo systematically evaluate the efficacy and safety of enteric-coated mycophenolate sodium (EC-MPS) versus mycophenolate mofetil (MMF) in kidney transplant recipients. MethodsWe searched MEDLINE, EMbase, PubMed, the Cochrane Library (Issue 9, 2013), CBM, CNKI, VIP and WanFang Data from their inception to November 2013, to collect randomized controlled trials (RCTs) of EC-MPS versus MMF in kidney transplant recipients. References of included studies were also retrieved. Two reviewers independently screened studies according to the exclusion and inclusion criteria, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.1 software. ResultsA total of 8 RCTs involving 2 400 patients were included. The results of meta-analysis indicated that there were no significant differences between the two groups at the end of 4-week, 6-month, 12-month and 48-month follow-up in the acute rejection rate (4-weeks:RR=0.33, 95%CI 0.01 to 8.05; 6 months:RR=0.94, 95%CI 0.73 to 1.22; 12 months:RR=0.88, 95%CI 0.63 to 1.24; 4 years:RR=0.93, 95%CI 0.47 to 1.84). There were no significant differences between the two groups at the end of 6-month and 12-month follow-up in the chronic rejection rate (6 month:RR=0.66, 95%CI 0.27 to 1.58; 12 month:RR=0.57, 95%CI 0.29 to 1.15). There were no significant differences between the two groups at the end of 6-month, 12-month and 48-month follow-up in the graft loss or death rate (6-month:RR=0.79, 95%CI 0.41 to 1.50; 12-month:RR=0.76, 95%CI 0.40 to 1.43; 48-month:RR=1.38, 95%CI 0.59 to 3.23). As to the side effect, EC-MPS could significantly reduce the risk of pneumonia compared with MMF (RR=0.32, 95%CI 0.13 to 0.79). ConclusionBased on current evidences, EC-MPS is comparable with MMF for renal transplant patients in short-term effectiveness, and the incidence of pneumonia in the EC-MPS group is lower than the MMF group. Due to the limited quantity and quality of the studies, the conclusions should be validated by more high quality studies.
Objective To explore the effect of membrane surface nucleolin （NCL） on activation of epidermal growth factor receptor （EGFR） signaling. Methods Immunohistochemistry was used to identify the expressions of membrane surface NCL or EGFR in pallilary thyroid carcinoma （PTC） tissues. The level of phosphorlated EGFR in TPC-1 cells was observed by Western blot. TPC-1 cells invasion capacity was detected by Transwell assay. Results The posi-tive expression rates of membrane surface NCL and EGFR in PTC tissues were 100% （56/56） and 80.4% （45/56） respe-ctively， while the expressions of NCL and EGFR were related with lymph node metastasis （P＜0.05）. There was posi-tive correlation between the expressions of NCL and EGFR （r=0.635， P＜0.01）. Western blot showed that anti-NCL or anti-EGFR of TPC-1 cells could inhibit the expression of phosphorlation EGFR （P＜0.01）. Transwell assay showed the number of membrane-invading cells were reduced significantly in anti-NCL group anti-EGFR group （P＜0.01）. Conclusions Membrane surface NCL may be a kind of indispensable component in activation of EGFR signaling， by which EGFR can participate in growth and invasion of tumors. NCL can be used as a target for developing a new field of tumor treatment.