Objective To evaluate the effectiveness and safety of sarpogrelate hydrochloride for patients with peripheral arterial disease (PAD). Methods The randomized controlled trials (RCTs) on PAD treated by sarpogrelate hydrochloride were identified from CBM (1978 to September 2011), CNKI (1979 to May 2011), PubMed (1950 to May 2011), EMbase (1970 to May 2011) and The Cochrane Library (Issue 3, 2011). According to the criteria of the Cochrane Handbook, two reviewers independently screened the studies, extracted and cross-checked the data, and assessed the methodological quality. Then meta-analysis was conducted by using RevMan 5.0 software. Results Nine RCTs involving 522 patients and 532 limbs were included, with low methodological quality in most trials. The results of meta-analyses indicated that compared with the conventional treatment, sarpogrelate hydrochloride could reduce the area of ulcers (MD= –3.22, 95%CI –3.99 to –2.45), and it could increase the ankle-brachial index (SMD=0.49, 95%CI 0.07 to 0.91), blood flow of dorsalis pedis artery (MD=0.16, 95%CI 0.09 to 0.23) and pain-free walking distance (MD=200.87, 95%CI 3.39 to 398.36). Five trials reported the adverse effects of sarpogrelate hydrochloride, most of which were mild gastrointestinal symptoms. Conclusion Based on the review, sarpogrelate hydrochloride may have positive effect on patients with PAD. However, the evidence is not b enough due to the general low methodological quality, so the reliable conclusion has to be drawn with more high quality studies in future.
ObjectiveTo explore the clinical effect of lidocaine mucilage diluent and simethicone emulsion in gastroscopy examination, in order to provide effective drugs for gastroscopy. MethodsWe selected 201 outpatients and the inpatients who underwent gastroscopic examination between August and October 2014 as the research subjects. Based on the kind of drug, the patients were randomly divided into research group (n=100) and control group (n=101). Patients in the research group accepted lidocaine mucilage diluent, while those in the control group received simethicone emulsion. Then we observed and compared the definition of gastroscopy, adverse drug reactions, examination time and drug price between the two groups. ResultsThe frequencies of high, medium, and low definition of gastroscopy were respectively 63.00%, 34.00% and 3.00% among the patients in the research group, and 69.31%, 26.73% and 3.96% among patients in the control group; there was no significant differences between the two groups (Z=-0.854, P=0.393). The adverse reaction rates, testing time, and drug prices for the two groups were 0.99% vs.1.00% (P>0.05), (6.5±2.1) minutes vs.(6.6±2.0) minutes (t=0.458, P>0.05), and RMB (9.0±1.2) yuan vs.(42.8±2.8) yuan (t=227.644, P<0.05), respectively. ConclusionLidocaine mucilage diluent and simethicone emulsion both have good effect for gastroscopic examination, which can raise the gastroscopic definition, promote endoscopic operation and observation by doctors, shorten examination time, and reduce adverse drug reactions. Both are of great value in clinical application, and lidocaine hydrochloride mucilage diluent is cheaper, which can be widely used and promoted clinically.
ObjectiveTo discuss the effect of glucosamine-hydrochloride (Glu/Ch) in protecting and repairing the cartilage in blood-induced joint damage (BJD) in vivo. MethodsThirty-two adult New Zealand rabbits were randomly divided into 4 groups (n=8):high-dose Glu/Ch treated group (group A), low-dose Glu/Ch treated group (group B), positive control group (group C), and negative control group (group D). A joint bleeding model was established by blood injection into articular cavity in groups A, B, and C. Glu/Ch was given by gavage in groups A (250 mg/kg) and B (21.5 mg/kg) once a day for 8 weeks, and the same dosage of saline was given in groups C and D. The serum cartilage oligomeric matrix protein (COMP), serum chondroitin sulfate 846(CS846), and urinary C-terminal telopepide of type II collagen (CTX-II) were measured at 3 days, 7 days, 2 weeks, and 8 weeks after modeling. The expressions of cytokines such as interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in synovial fluid were analyzed by ELISA at 8 weeks after modeling. The expression of matrix metalloproteinase 13(MMP-13) was detected by immunohistochemistry. Alcian blue staining and Safranin-O staining were performed to calculate the percentage of the positive staining areas. The proteoglycan content was detected by semi-quantitative analysis in the articular cartilage. ResultsThe COMP concentration was significantly higher in groups A, B, and C than group D, and in groups B and C than group A at 3 days after modeling (P<0.05); no significant difference was found among groups A, B, and D at 7 days (P>0.05), and it was significantly lower in groups A, B, and D than group C (P<0.05); there was no significant difference among 4 groups after 2 and 8 weeks (P>0.05). Difference in CS846 concentration had no significance among 4 groups at each time point (P>0.05). The CTX-II concentration of groups A, B, and C was significantly higher than that of group D at each time point (P<0.05); it was significantly lower in group A than groups B and C at 7 days, 2 weeks, and 8 weeks (P<0.05). The TNF-α concentration of groups A and B was significantly higher than group D, and was significantly lower than group C at 8 weeks (P<0.05), but no significant difference was observed between groups A and B (P>0.05). The IL-1β concentration was significantly higher in group C than the other groups (P<0.05), and in group B than groups A and D (P<0.05), but there was no significant difference between groups A and D (P>0.05). The MMP-13 expression was significantly higher in group C than groups A, B, and D (P<0.05), in groups A and B than group D (P<0.05). A significant decrease in the area stained with Alcian blue and Safranin-O was observed in group C. There were significant differences in the percentage of the positive stained areas of Alcian blue and Safranin-O among 4 groups (P<0.05). The relative quantities of proteoglycan from small to large in order was groups C, B, A, and D, respectively, showing significant differences (P<0.05). ConclusionThe metabolism disorder of cartilage matrix and synovium inflammatory reaction can be observed in rat joint bleeding model. Glu/Ch has certain protective effect on the cartilage after BJD by down-regulating IL-1β, TNF-α, and MMP-13, as well as increasing proteoglycan content in the cartilage.
目的 观察比较盐酸氨基葡萄糖单独使用及与硫酸软骨素联合使用治疗腰椎小关节骨关节炎（LFOA） 的临床疗效。 方法 2009年1月－2011年1月，将80例LFOA患者随机分成两组，A组口服盐酸氨基葡萄糖，B组口服盐酸氨基葡萄糖和硫酸软骨素两种药物，6周为1个疗程，间断治疗4个疗程。分别比较用药前与用药后3、6周及5、8、11个月时的日本骨科协会（JOA）评分、晨僵和压痛程度变化。 结果 治疗后，两组的JOA评分在各观察时点均增加，与治疗前比较差异有统计学意义（P＜0.05）。组间行JOA评分治疗改善率的比较，在各观察时点差异均有统计学意义（P＜0.05），B组JOA评分改善率优于A组。治疗3周后，两组晨僵和压痛评分均降低，与本组治疗前比较差异有统计学意义（P＜0.05）；组间比较，差异亦有统计学意义（P＜0.05），B组晨僵和压痛程度均低于A组。第6周，第5、8、11个月，两组组间比较晨僵和压痛程度差异均无统计学意义（P＞0.05），但各疗程结束后两组晨僵和压痛程度均呈持续降低趋势。 结论 单独应用盐酸氨基葡萄糖及盐酸氨基葡萄糖与硫酸软骨素的联合应用治疗LFOA疗效确切，联合用药优于单独应用盐酸氨基葡萄糖。
目的 研究盐酸氨基葡萄糖联合抗骨增生片治疗膝骨关节炎（KOA）的可行性及安全性。 方法 2011年1月－2012年8月选取90例KOA患者，按关节面改变部位归入A组（髌股关节面改变）、B组（胫股关节面改变）、C组（全关节软骨改变），每组30例。均予以盐酸氨基葡萄糖、抗骨增生片治疗，12周后观察治疗前后临床疗效、综合疗效及安全性等指标及评分。 结果 ① 3组比较，A组疗效高于B、C组（P＜0.05）；② A组与B、C两组在平地行走20 m疼痛评分、关节压痛度评分和骨关节炎指数（WOMAC）评分方面差异有统计学意义（P＜0.05）；③ A组和B、C两组在患者自我疗效评价、医生疗效评价方面差异有统计学意义（P＜0.05）；④ A组在治疗12周后血液血沉、C反应蛋白（CRP）、白细胞介素（IL）-1、IL-6、肿瘤坏死因子-α（TNF-α）较治疗前差异有统计表学意义（P＜0.05）；B组则在CRP、IL-6、TNF-α较治疗前有差异（P＜0.05）；C组仅在CRP、TNF-α较前有差异（P＜0.05）；⑤3组不良反应发生率则无明显差异（P＞0.05）。 结论 盐酸氨基葡萄糖联合抗骨增生片治疗髌股关节面改变的KOA疗效优于胫股关节改变，且治疗方案可行、安全、优效。
ObjectiveTo investigate the clinical efficacy of sarpogrelate hydrochloride in preventing restenosis after femoral artery stent implantation. MethodsTwo hundreds and fifty-one cases of ischemic disease of lower extremity (286 affected limbs in total) who got treatment in our hospital were collected, and were divided into prevention group(125 cases with 146 affected limbs) and control group(126 cases with 140 affected limbs) according kinds of medicine. At the basement of medicine in control group, cases of prevention group got treatment of sarpogrelate hydrochloride in addition. Comparison of related indexed was performed by SPSS 17.0 software. ResultsCompared with before treatment in prevention group, only foot skin ulcer and gangrene score decreased(P<0.05), and there were no significant difference on other indexes included visual anafogue scales(VAS), intermittent claudication distance score, ankle brachial index (ABI), and vascular stenosis score(P>0.05). But in control group, compared with before treatment, foot skin ulcer and gangrene score and ABI value decreased(P<0.05), the VAS score, intermittent claudication distance score, and vascular stenosis score increased(P<0.05). There were significant difference on the difference between after treatment and before treatment of all 5 indexes(P<0.05), that the changed value of foot skin ulcer and gangrene score was higher in prevention group, but lower on other 4 indexes. There were no untoward effect happened during treatment. ConclusionClinical effect of sarpogrelate hydrochloride in the prevention of restenosis of the femoral artery after stent implantation was significantly, and it can keep related indexes stable.
目的 观察盐酸氨基葡萄糖对Pilon骨折的辅助治疗作用。 方法 2007年6月－2010年9月，将43例接受手术治疗的Pilon骨折患者随机分成两组，A组术后口服盐酸氨基葡萄糖，B组作为对照组（仅服用安慰剂）。A组21例患者，平均年龄（35.7± 8.0）岁，B组22例患者，平均年龄（36.7 ± 7.1）岁。两组患者年龄、性别、骨折分型及手术时机相比较，无统计学差异（P＞0.05）。定期随诊（术后6、12、18个月），根据美国足与踝关节协会踝与后足功能评分（AOFAS）评分系统对患者进行功能评分，进行前瞻、对照、双盲研究。 结果 术后6、12、18个月，A组患者的AOFAS评分均明显高于B组，差异有统计学意义（t=2.530，2.856，2.881；P=0.015，0.007，0.006）；术后18个月，A组临床疗效优良率为95.2%，B组优良率为72.3%，差异有统计学意义（χ2=3.995，P=0.046）。A组2例患者分别发生轻度头晕及恶心，无严重不良反应发生。 结论 盐酸氨基葡萄糖辅助治疗Pilon骨折可改善踝关节功能，减少创伤性骨关节炎的发生。
Objective To observe whether additional penehycl idine hydrochloride (PHC) in mechanical ventilation produces therapeutic effect on oleic acid (OA) induced acute lung injury (ALI) in canine. Methods Seventeen male canines (weighing 12-17 kg) were divided into control group (n=5), OA group (n=6) and PHC group (n=6). ALI model was developed by central venous injection of OA in canines of OA and PHC groups. ALI model was kept steady in air, all groups received mechanical ventilation 90 minutes later. Three groups received normal sal ine 0.25 mg/kg without injection of OA(control group), normal sal ine 0.25 mg/kg after injection of OA (OA group) and PHC 0.25 mg/kg after injection of OA (PHCgroup) respectively at 0 h (90 minutes after onset time of ALI/ARDS). The heart rate (HR), mean arteial pressure (MAP), mean pulmonary arterial pressure (MPAP), central venous pressure (CVP), pulmonary artery wedge pressure (PAWP), artery blood gas analysis, cardiac output (CO), extravascular lung water index (EVLWI), FiO2 and VT were observed respectively at basel ine, onset time of ALI/ARDS and 0 h, then again at 1 hour intervals for 6 hours. Besides the above, airway peak pressure (Ppeak), airway plat pressure (Pplat), mean airway pressure (Pmean) and positve end-expriatory pressure (Peep) were also observed each hour during 1-6 hours. Oxygenation index (OI), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), alveolar-arterial differences for O2 (AaDO2) and dynamic lung compl iance (DLC) were calculated and pulmonary tissue was collected for histopathologic investigation and dry wet weight ratio (WDR) test. Results The functional parameters of PHC group were improved when compared those of OA group, but there was no siginficant difference; WDR of independent region of three groups were 80.42% ± 3.48%, 82.67% ± 4.01% and 82.26% ± 1.43% respectively; WDR of dependent region of three groups were 80.51% ± 3.60%, 83.71% ± 1.98% and 82.57% ± 1.08% respectively. WDR of PHC group were obviously improved when compared with those of OA group, but there was no significant difference. Independent and dependent regions of PHC group were significantly improved when compared those of OA group in histopathologic scores, alveolar edema, inflammatory infiltration and over-distension (P lt; 0.01). Conclusion Additional PHC in mechanical ventilation produces obvious therapeutic effect on OA induced acute lung injury in canine.