ObjectiveTo investigate the protective effect and the regulation mechanism of oxaloacetate (OAA) on myocardial ischemia reperfusion injury in rats. MethodsSixty rats, weight ranged from 200 to 250 grams, were randomly divided into 6 groups:a negative control group, a sham operation control group, a model control group, an OAA pretreatment myocardial ischemia-reperfusion model group (three subgroups:15 mg/kg, 60 mg/kg, 240 mg/kg). We established the model of myocardial ischemia reperfusion of rats and recorded the internal pressure of left ventricle (LVSP), the maximal rate of left ventricular pressure change (±dp/dtmax) and left ventricular end diastolic pressure (LVEDP). We restored reperfusion 180 minutes after ligating the left anterior descending coronary artery 30 minutes and determinated cardiac troponin Ⅰ (cTn-I), lactate dehydrogenase (LDH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px). We took out heart tissues, stained it and calculated the infarcted size. We used the Western blot to detect the expression of NF-E2 related factor 2 (Nrf2), Kelch-like ECH-associated protein-1 (Keap1) and heme oxygenase-1 (HO-1). ResultsCompared with the sham operation group, heart function indexes in the negative control group had no significant difference (P>0.05). But in the model control group there was a decrease (P<0.05) And the serum levels of LDH, cTn-I, and myocardial infarcted size were significantly increased (P<0.01). Compared with the model control group, heart function indexes in the OAA pretreatment groups improved, the serum LDH, cTn-I activity, and infarct size decreased (P<0.05), SOD and GSH-Px activity increased (P<0.05). And these results were statistically different (P<0.01) in the high dose OAA pretreatment groups. Compared with the model control group, the expression of Keap1 in the OAA pretreatment group was down-regulated (P<0.001) while total Nrf2, nucleus Nrf2 and its downstream HO-1 was up-regulated (P<0.001), which suggested that OAA enhanced antioxidant capacity by (at least in part) Keap1-Nrf2 pathway, resulting in reducing myocardial damage and protecting myocardium after acute myocardial ischemia reperfusion injury. ConclusionOxaloacetate can provide protective effects on myocardial ischemia reperfusion injury through down-regulating the expression of Keap1 and up-regulating the expression of Nrf2 and its downstream peroxiredoxins to improve antioxidant capacity.
The resistance of non-small cell lung cancer (NSCLC) to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has been brought into focus. COX-2 signal pathway was found to be closely related to EGFR signal pathway by recent researches, and there has been a growing interest to focus the researches on whether COX-2 pathway inhibition improves the efficacy of EGFR-TKIs in treating advanced NSCLC. In this review, we will illustrate recent advances of combined inhibition of EGFR and COX-2 signal pathways in NSCLC therapy.
Objective To observe the short-term effect and safety of hyperbaric oxygen combined with edaravone and ozagrel sodium in treating progressive cerebral infarction. Methods A total of 65 in-patients with acute progressive cerebral infarction were randomly divided into two groups: 33 in-patients in the trial group were treated by hyperbaric oxygen combined with edaravone and ozagrel sodium, while the other 32 in-patients in the control group were treated by edaravone and ozagrel sodium. The course of treatment was 14 days. The following indications were assessed before and after the treatment respectively: the national institutes of health stroke scale (NIHSS), activities of daily living (ADL), and clinical effects. Results This study showed that the scores of both ADL and NIHSS in the trial group were higher than those in the control group, with significant differences (Plt;0.05). The clinical effective rate of the trial group was 90.91% which was obviously higher than the control group with a significant difference (P=0.028). There were no obvious adverse reactions in both groups. Conclusion Hyperbaric oxygen combined with both edaravone and ozagrel sodium is notable in short-term effect and safe, thus it is worth being popularized in clinical treatment.
Objective To assess the efficacy and safety of hyperbaric oxygen treatment for patients with post-stroke depression. Methods Randomized controlled trials (RCTs) about hyperbaric oxygen treatment with placebo or open control in patients with post-stroke depression were comprehensively retrieved in PubMed (1966 to 2012.12), EMbase (1974 to 2012.12), EBSCO (1965 to 2012.12), CENTRAL (2012.11), CBM (1978 to 2012.12), CNKI (1980 to 2012.12), and VIP (1989 to 2012.12). References of the included articles were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.0. Results Twelve trials involving 822 patients were included, all of which were randomized non-placebo controlled trials. The results of meta-analysis of 12 trials (n=822) showed, the improvement of depression symptoms in the HBO group was better than that in the control group (MD=4.82, 95%CI 3.12 to 6.52). However, funnel plot showed that publication bias was large. After removing three trials for sensitive analysis, the results showed that the improvement of depression symptoms in the HBO group was still better than that in the control group (MD=3.91, 95%CI 3.35 to 4.47). Adverse events were reported in 2 trials, including dizziness, palpitation, mild earache, tinnitus, etc. However, no severe adverse events occurred. Conclusion Current evidence indicates that, HBO can effectively reduce the score of HAMD and no serious adverse reactions occurred. It’s necessary to further carry out high quality randomized controlled trials with large sample size due to limited quality and quantity of the included studies, so as to assess its effectiveness and safety.
Objective To systematically review the effectiveness and safety of linezolid versus teicoplanin in patients with MRSA pneumonia. Methods Such databases as CBM, CNKI, WanFang Data, VIP, Science Direct, PubMed, Ovid, SciFinder, The Cochrane Library (Issue 3, 2013) and EMbase were electronically searched for published articles (randomized controlled trials or non-randomized prospective trials with comparable baseline between groups) at home and abroad on the clinical effectiveness and safety of linezolid versus teicoplanin in patients with MRSA pneumonia from January 2003 to March 2013. Using the Cochrane methods, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software in clinical cure rates, clinical effective rates, microbiologic eradication rates, and adverse reaction incidences. Results Finally, 7 studies were included involving 637 patients. The results of meta-analysis were clinical effective rates (RR=1.17, 95%CI 1.04 to 1.32, P=0.009), clinical cure rates (RR=1.06, 95%CI 0.94 to 1.19, P=0.37), bacterial clearance rates (RR=1.32, 95%CI 1.03 to 1.68, P=0.03), and adverse events rates (RR=1.24, 95%CI 0.78 to 1.97, P=0.37). The results of Begg test and Egger test were not significant (Pgt;0.05). Conclusion Current evidence shows that, in treating MRSA pneumonia, linezolid is better than teicoplanin in clinical effective rates and bacterial clearance rates. However, they are alike in clinical cure rates and bacterial clearance rates.
Objective Application of auditory brainstem response (ABR) in the study on the relationship of neonates with hypoxic-ischemic encephalopathy (HIE) and the children with hearing loss and auxiliary determine the prognosis of encephalopathy. Methods We prospectively selected neonates diagnosed as HIE in the department of neonatology of the Chengdu Women and Children Central Hospital from January, 2006 to June, 2008. Neonatal ABR was tested and the prognosis of neonates were observed through 3-year followed up in order to analyze the relationship between HIE severity and the severity of hearing handicap and the relationship between the severity of hearing handicap and prognosis. Statistical analysis was performed using SPSS 18.0. χ2 test was used to compare the rate between groups. Results 40 cases involving 80 ears were included, of which 33 cases accomplished the 3-year follow-up for prognosis. The results showed that, 86.3% HIE neonates had hearing handicap (mainly mild hearing loss, 40.0%). Medium-severe HIE groups had more serious hearing handicap than Mild HIE group with a statistical significance (continuity correction χ2=7.383, P=0.007). ABR results showed that, mild HIE is mainly manifested as I wave PL prolonged or poorly differentiated, accounting for 78.1%; medium - severe HIE are mainly manifested as III and V wave PL prolonged central segment abnormalities, accounting for 95.8%; the hearing threshold no more than 60 dB group had better prognosis than the hearing threshold more than 60 dB group prognosis (Fisher exact probability P=0.001). Conclusion ABR reflects that HIE severity and was positively related to the severity of hearing handicap. The more serious hearing loss in neonates is, the worse prognosis the neonates have. ABR can be used to assist the assessment of the prognosis of neonatal HIE.
Objective To evaluate the clinical efficacy and safety of sparfioxacin in treatment of the acute respiratory tract infections. Methods A randomized-controlled clinical trial was carried out. Sparfloxaein 200 mg once daily and ofioxacin, as a control drug, 200 mg twice a day, both drugs were given by infusion for 7-14 days. There were 30 cases in each group. Results The clinical cure rates and the clinical efficacy rates of the two groups were 33.33%, 26.67%, and 80.00%, 76.67 % respectively. The bacterial clearance rates were 89.66% and 89.29% respectively. The adverse drug reaction rates were 13.33% and 16.67% respectively. There were no statistical differences between the two groups (Pgt;0.05). Photosensitive reaction was not observed in this study. Conclusion Sparfloxacin was effective in the treatment of the respiratory infections.
Objective To assess the clinical effectiveness and safety of inductive treatment with arsenic trioxide （As203） for acute promyelocytic leukemia （APL）. Methods Randomized controlled trials （RCTs） were identified from MEDLINE （1966 -July, 2005 ）, EMBASE （1984 -July, 2005 ）, The Cochrane Library （ Issue 3, 2005） and CBM- disc （1978 -July, 2005）. The references of eligible studies were handsearched. RCTs of As203 treating for APL were included. Data were evaluated and extracted by two reviewers independently with designed extraction form. RevMan 4. 2.7 software was used for data analysis. Results Six RCTs involving 323 patients were included. Two studies reported that there was no statistical difference between As2O3 group and all-transretinoic acid （ATRA） group in mortality for patients with APL or APL patients with complications of desseminated intiavascular coagulation or cerebra hemorrhage. The pooled result of 4 studies showed that there was no statistical difference with RR 0.98, 95 % CI 0.86 to 1.12 in complete remission （CR） rates between the two groups. The result of one study showed that the CR rate of patients with intravenous injection of As203 in 2 divided dosages with longer injection duration was higher with RR 1.31, 95% CI 0.86 to 1.12 compared with those with a single intravenous injection. Adverse effects in As2O3 group were less than ATRA group. Conclusions Inductive treatment with As2O3 for acute promyelocytic leukeuia has similar mortality and CR with less adverse effects compared with ATRA. More trials of high quality are required.
Object To collect and summarize high quality clinical evidence on the use of hyperbaric oxygen (HBO) in health care generally. Method We searched MEDLINE (1980-2006), The Cochrane Library (Issue 1, 2006) and the China Biomedicine Database (1982-2006) for systematic reviews, meta-analyses and randomized controlled trials. The quality of included studies was critically evaluated. Result Thirteen systematic reviews (12 Cochrane reviews) on HBO were included. Results showed that HBO had some beneficial effect on acute coronary syndrome, ischemic stroke, multiple sclerosis, malignant otitis externa, idiopathic sudden sensorineural hearing loss and tinnitus. It might also promote chronic wound healing and relieve radiation damage.Conclusions Since the avaliable randomized controlled trials for the systematic reviews we included are too small, further well-designed multicentre large-scale trials are needed to determine the efficacy and safety of HBO .
ObjectiveTo explore the clinical features of atypical bronchial asthma with chief complaint of palpitations. MethodsTwelve cases with unexplained palpitations diagnosed by asthma were analyzed retrospectively. ResultsThe patients were diagnosed with asthma through bronchodilation test,skin prick tests,fractional exhaled nitric oxide (FeNO) and diagnostic treatment.The ratio of male to female cases was 1:5. The ventilation lung function of all patients was in normal range. The median time of misdiagnosis was 13.5(3-120) months. 41.6% of cases had dust mite positive skin prick test. The median value of FeNO was 32.75(18-54) ppb. The symptoms of all patients were relieved completely after standard treatment. ConclusionPalpatation may be a specific presentation of asthma characterized with eosinophilic airway inflammation which may be misdiagnosed as other diseases for a long time,especially in elder women. To improve the knowledge of this kind of atypical asthma,detailed medical history, experimental examinations and diagnostic treatment response are important to confirm the diagnosis in time.