ObjectiveTo review the research progress of constructing injectable tissue engineered adipose tissue by adipose-derived stem cells (ADSCs). MethodsRecent literature about ADSCs composite three-dimensional scaffold to construct injectable tissue engineered adipose tissue is summarized, mainly on the characteristics of ADSCs, innovation of injectable scaffold, and methods to promote blood supply. ResultsADSCs have a sufficient amount and powerful ability such as secretion, excellent compatibility with injectable scaffold, plus with methods of promoting blood supply, which can build forms of injectable tissue engineered adipose tissue. ConclusionIn despite of many problems to be dealt with, ADSCs constructing injectable tissue engineered adipose tissue may provide a promising source for soft-tissue defect repair and plastic surgery.
Objective To systematically assess the effectiveness and safety of 5-HT3 receptor antagonists in preventing propofol injection induced pain. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2012), CNKI, CBM, VIP and WanFang Data were searched from their inception to September, 2012 to collect the randomized controlled trials (RCTs) about 5-HT3 receptor antagonists in preventing propofol injection induced pain. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality of methodology. Then meta-analysis was performed using RevMan 5.2 software. Results A total of 15 RCTs involving 1 413 patients were included. The results of meta-analysis showed that: a) the incidence of propofol injection induced pain in the 5-HT3 group was obviously lower than the control group (RR=0.14, 95%CI 0.09 to 0.21, Plt;0.000 01); b) as to the severity of pain, there was no statistical difference between the two groups (RR=0.84, 95%CI 0.56 to 1.26, P=0.39); the 5-HT3 group was obviously lower that the control group in the incidence of both moderate pain (RR=0.25, 95%CI 0.19 to 0.34, Plt;0.000 01) and severe pain (RR=0.16, 95%CI 0.10 to 0.24, Plt;0.000 01); and c) as to the incidence of postoperative adverse reaction: the 5-HT3 group was obviously lower that the control group in the incidence of nausea and vomiting (RR=0.19, 95%CI 0.11 to 0.34, Plt;0.000 01) and shivering (RR=0.20, 95%CI 0.12 to 0.33, Plt;0.000 01) as well. Conclusion 5-HT3 receptor antagonists can effectively prevent the propofol injection induced pain, alleviate its severity, and reduce the postoperative adverse reactions. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.
Objective To systematically review the effects of lidocaine for preventing pain on injection of propofol. Methods Databases including The Cochrane Library (Issue 4, 2012), PubMed, MEDLINE, Ovid, HighWire, EMbase, CBM and CNKI were searched electronically to collect literature published from January, 1985 to December, 2012. Randomized controlled trials (RCTs) were indentified about lidocaine for preventing injection pain of propofol. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assess the quality of the included studies. Then meta-analysis was performed using RevMan 5.1 software. Results Fifteen trials involved 1 332 patients were included. The results of meta-analysis indicated that, adding lidocaine into propofol lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.36, 95%CI 0.30 to 0.44, Plt;0.000 01); using different doses of lidocaine before injection lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.59, 95%CI 0.47 to 0.75, Plt;0.000 1); using different doses of lidocaine after venous occlusion lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.44, 95%CI 0.37 to 0.52, Plt;0.000 01). Conclusion Lidocaine could reduce the pain on injection of propofol. Using lidocaine 40 mg after venous occlusion is a relatively effective method to lower the incidence of pain on injection which is more suitable for outpatient who receive intravenous anesthesia without preoperation medication.
Objective To assess the efficacy and safety of Dan Hong injection for patients with angina pectoris compared with compound salvia injection as the control group. Methods Databases were electronically searched from MEDLINE, EMbase, CBM, CNKI, VIP, and Wanfang Data (January, 2007 to July, 2010), and reference lists of all papers identified were also checked. Randomized controlled trials (RCTs) of the effect of Dan Hong injection on angina pectoris were identified and assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and then RevMan 4.3 was used to undertake Meta analysis. Results Twenty-seven trials involving 3 030 patients were included. Meta-analysis showed that: a) Compared with compound salvia injection, Dan Hong injection was capable of significantly decreasing the angina incidence (OR=3.84, 95% CI 3.03 to 4.88, Plt;0.000 01); b) Dan Hong injection was capable of significantly improving ECG review effectiveness compared with compound salvia injection (OR=1.98, 95% CI 1.44 to 2.66, Plt;0.000 01); c) Dan Hong injection was obviously superior to compound salvia injection in improving the NST (WMD= 0.78, 95%CI 0.42 to 1.14, Plt;0.000 1) and ∑ST (WMD= 0.45, 95%CI 0.32 to 0.57, Plt;0.000 01); and d) Dan Hong injection was able to obviously improve the hemorheology index after angina pectoris; Meta-analyses of eight trials in which adverse events were reported showed that no significant difference was found between Dan Hong injection and salvia injection (OR=0.64, 95%CI 0.33 to 1.25, P=0.19). Conclusion Dan Hong injection can effectively improve the ST segment ischemia and hemorheology index after angina pectoris, significantly increase the effectiveness of electrocardiogram reviews and eventually significantly reduce the recurrence rate of angina, and appears to be much safer. Further high quality RCTs are required to provide reliable evidence on the treatment of patients with angina pectoris.
Objective To evaluate the efficacy and safety of COX inhibitor flurbiprofen axetil in relieving propofol injection pain and preemptive analgesia after general anesthesia. Methods Databases such as PubMed, CBM, Springer, Ovid, CNKI and ISI were searched to identify randomized controlled trials (RCTs) about flurbiprofen axetil in relieving propofol injection pain and preemptive analgesia after general anesthesia published from 2000 to 2010. The methodological quality of the included RCTs was assessed and the data were extracted according to the Cochrane Handbook 5.0.1. Meta-analysis was performed by using RevMan 4.2.10 software. Results A total of 15 RCTs involving 1 425 patients were included. The results of meta-analyses showed that: a) Relieving propofol injection pain: Compared with the placebo group, flurbiprofen axetil could prevent the propofol injection pain (RR=3.13, 95%CI 1.08 to 9.11, P=0.04), and relieve the moderate and severe pain in injecting propofol (RR=0.57, 95%CI 0.40 to 0.81, P=0.002; RR=0.14, 95%CI 0.05 to 0.34, Plt;0.000 1, respectively), but there were no significant differences in relieving mild pain between the two groups; b) Preemptive analgesia: the visual analog scale (VAS) of post-operation at 2-hour (WMD= –2.25, 95%CI –4.20 to –0.29, P=0.02), 4-hour (WMD= –1.99, 95%CI –3.19 to –0.79, P=0.001), 8-hour (WMD= –1.39, 95%CI –1.86 to –0.93, Plt;0.000 01) and 12-hour (WMD= –2.70, 95%CI –4.73 to –0.68, P=0.009) was decreased when flurbiprofen axetil was injected before the operation, but there were no significant differences in VAS of post-operation at 48-hour between the two groups. When flurbiprofen axetil was injected at the end of the operation, VAS of post-operation at 12-hour (WMD= –0.94, 95%CI –1.73 to –0.16, P=0.02) was decreased, but there were no significant differences in VAS of post-operation at 24-hour between the two groups; flurbiprofen axetil could lessen the need for opioid analgesics (RR=0.47, 95%CI 0.27 to 0.82, P=0.008); and c) Safety: there were no significant differences in postoperative nausea, vomit and somnolence between the two groups. Conclusion Flurbiprofen axetil can significantly prevent or relieve the propofol injection pain; flurbiprofen axetil injected before operation can relieve post-operative pain at 2-, 4-, 8- and 12-hour; flurbiprofen axetil injected at the end of the operation can relieve post-operative pain at 12-hour. Yet more RCTs are required to discuss its effects on nausea, vomit and somnolence.
Objective To evaluate the efficacy and safety of Salviae miltiorrhizae Injection (include Danshen Injection and Fufang Danshen Injection) for chronic cor pulmonale. Design A systematic review of randomized clinical trials. Method Randomized trials comparing Salviae miltiorrhizae Injection plus routine treatment versus muting treatment alone were identified by electronic and manual searches. No blinding and language limitations were applied. The Jadad scale assessed the methodological quality of trials. Results Thirty randomized trials (n=2 161) were identified. The methodological quality of all trials included was low. The combined results (RR and 95%CI) of symptom scores was 1.20 (1.15 to 1.26). Because of the significant heterogeneity, many other markers of the blood rheology can not be combined. The reason for heterogeneity should include the differences among cases and studies. Because of lacking enough studies, the conclusions about mortality and oxidants/antioxidants markers were not b. Only a few studies had reported adverse events. Conclusions Based in the review, Salviae miltiorrhizae Injection may have positive effect on symptom scores in patients with chronic cor pulmonale. But for mortality, the markers of blood rheology and oxidants/antioxidants, there is no reliable conclusion. However, the evidence is not b due to the general low methodological quality, the variations among studies and experimental markers themselves, and lacking of more relevant and important markers. Further large trials are needed.
Objective To assess the methodological quality of clinical studies using Shen-Mai injection as an adjunct therapy to tumor chemotherapy and to evaluate its efficacy and safety. Methods A comprehensive search strategy was designed to identify all randomized controlled trials (RCT) comparing Shen-Mai injection plus routine chemotherapy versus routine chemotherapy alone by searching for the CBMdisc (issue 3) and TCMLRS database (1981-2001). The methodological quality of the trials was assessed by two reviewers independently for which a meta analysis was perfermed. Results Thirteen RCTs met the inclusion criteria. methodological quality was poor (all the trials included were level C). Compared with the control group, the combined outcome of Shen-Mai injection increased the effect of chemotherapy (OR 1.73 95%CI 1.27 to 2.34, P＝0.000 4), reduced the side effect of bone marrow inhibition (OR 0.29, 95%CI 0.16 to 0.52, P＝0.000 04) in WBC counting and (OR 0.11, 95%CI 0.02 to 0.49, P＝0.004 in PLT count. And Shen-Mai injection relieved the symptoms of nausea and vomiting (OR 0.26, 95%CI 0.16 to 0.43, Plt;0.000 01). Conclusions The methodological quality of the trails using Shen-Mai injection should be improved. Based on the results of the review and the meta-analysis, Shen-Mai injection may have positive effects on chemotherapy in patients with malignant tumor, although the evidence is weak. No serious adverse events are reported. Further well-designed clinical trials should be performed.
Objective To evaluate the clinical effectiveness and safety of gastrodin injection in the treatment of vertigo. Methods A multi-center, single-blind randomized controlled trial was designed to study 240 vertigo patients who were randomly allocated into the treatment and the control groups.Patients in the treatment group were treated with gastrodin injection 600 mg, intravenously guttae, daily for 7 days, while those in the control group were treated with betahistin 30 mg, intravenously guttae, daily for 7 days. All data were analyzed by SAS. CMH (Cochran’s and Mantel-Haenszel) method was used to compare the clinical effect between the two groups. Nonparametric statistics and t-test were used in baseline data analysis. Results ① The clinical effectivenes on vertigo: according to the intention-to-treat (ITT) analysis, the clinical control rate and effective rate in the treatment group (n=117) were 71.19% and 90.60%, respectively, while 54.17% and 77.50% were in the control group (n=120). A statistic significance difference was found between the two groups (P=0.005 and P=0.004 for control and effective rate respectively).According to the per-protocol population (PP) analysis, the clinical control rate and effective rate in the treatment group (n=116) were 72.41% and 91.38%, respectively, and were 54.70% and 77.78% in the control group (n=117). Statistic significance was found between the two groups (P=0.005 and P=0.004 respectively). ITT and PP analysis revealed similar results. ② The clinical effect on vestibular function: the clinical control rate and effective rate were 62.26% and 81.13% respectively in the treatment group (n=53), and were 42.37% and 76.27% in the control group (n=58). Statistic significance was found in the clinical control rate but was not found in the effective rates between the two groups (P=0.029 and P=0.504, respectively). ITT and PP analysis revealed the same results. ③ Adverse drug reactions (ADRs) were slight to moderate. ADRs rates were 8.33% in the treatment group (n=120) and 10.83% in the control group (n=120), respectively. No statistic significance was found between the two groups(P=0.538). Conclusions Gastrodin injection and betahistine injection are safe and effective drugs for vertigo; gastrodin injection is better than betahistine injection in relieving vertigo symptoms.
Objective To compare effects of intra-articular injection of corticosteroid or viscoelastic agent alone or a combination of the two drugs for treatment of temporomandibular joint disorders. Methods A prospective quasirandomized controlled trial was conducted to compare 3 treatment protocols of intra-articular injections in the upper compartment of the joint immediately following arthrocentesis repeatedly every 10 days: ① triamcinolone 8 mg alone for 3 times, ② 1% hyaluronate 1 ml alone for 4 times, and ③ triamcinolone 8 mg for 2 times then 1% hyaluronate 1 ml for 2 times. Clinical examinations were done at baseline, 1, 12, and 24 months after end of the treatments. According to improvement of the symptoms and clinical signs, the effectiveness was graded in 3 classes: excellent, better, no change, or worse. The first two were classified as effective. Effective rates of the treatments and subgroups were compared statistically. Results Five hundred and sixty four patients with temporomandibular disorders were included and randomly allocated to 3 groups with 188 patients in each group. The rate of lost follow up at 24 months was 6.9% to 10.1%. At one month after treatment, the triamcinolone group had a better effective rate at 92.0%. At 12 and 24 months of follow up, effective rates of the hyaluronate group were better than those in the triamcinolone alone group (84.6% vs. 54.1% and 83.4% vs. 40.4%). Effective rates of combining triamcinolone and hyaluronate group at 12 and 24 months were 90.4% and 66.3% respectively. Conclusion Intra-articular injection of corticosteroid has better results in a short term and hyaluronate has better results in a long term in the treatment of temporomandibular joint disorders.
目的 评价参附注射液治疗老年人心力衰竭疗效和安全性。 方法 计算机检索Cochrane图书馆，Medline（1950年－2013年10月），Embase（1980年－2013年10月），中国知网（1979年1月－2013年10月）、万方（1986年1月－2013年10月）、维普（1989年1月－2013年10月）数据库，全面收集参附注射液联用西药常规治疗（试验组）与西药常规治疗疗效（对照组）比较的随机对照试验（RCT），分别由2名研究者根据纳入与排除标准，独立筛选文献、提取资料并评价文献质量，采用Revman 5.1软件进行Meta分析。 结果 共纳入8个研究559例患者，研究质量均为C级。Meta分析结果显示：与对照组比较，试验组临床疗效明显提高、症状改善[RR=1.20，95%CI（1.11，1.29），P＜0.000 01]，左室舒张末期内径减小明显[MD=5.90，95%CI（3.97，7.84），P＜0.000 01]、6 min步行试验距离增加[MD=62.48，95%CI（43.12，81.84），P＜0.000 01]，但左室射血分数两组差异无统计学意义[MD=4.79，95%CI（－0.07，9.65），P=0.05]。 结论 参附注射液与西药常规治疗联用能进一步提高老年心力衰竭患者的临床疗效，且安全性较好。