Objective To investigate the current situation of randomized controlled trials (RCTs) on compound salvia pellet (CSP) for angina pectoris and assess whether there is adequate evidence for clinical practice. Methods We collected all the published clinical studies on CSP for angina pectoris from 1994 to December 2005, and assessed each included report using the Jadad scale, the revised CONSORT statement and other self-edited items. Results We finally identified 115 RCTs. Among which, 1 scored 3 points, 6 scored 2 points, 106 scored 1 points and 2 socred 0 points. No RCT performed allocation concealment according to the CONSORT criteria, only 4 RCTs (3.5%) described the generation of the randomization sequence, among which 2 were quasi-randomized. No RCT provided randomization implementation,1 RCT (0.9%) carried out placebo control, 1 RCT (0.9%) reported endpoint, 9 RCTs (7.8%) adopted single blinding, 4 RCTs (3.5%) reported double blinding, 11 RCTs (9.6%) calculated statistical values, 2 RCTs (1.7%) provided the record of follow-up, 1 RCT (0.9%) reported negative outcome, 25 RCTs (21.8%) described adverse events, no RCT described how the sample size was estimated, and how an intent-to-treat (ITT) analysis and correlation analysis were reported, 1 RCT (0.9%) was multi-center, no RCT completed ethical approval and informed consent, 27 RCTs (23.5%) described syndrome type of TCM. Conclusion Currently, the methodology and reporting of studies on CSP for angina pectoris are not good enough to provide reliable evidence for clinical practice.
Objective To summarize the therapeutic experiences of abdominal wall bulge repair with compound patch intraperitoneal placement. Methods From October 2005 to October 2008, intraperitoneal onlay mesh with compound patch applied in 7 patients with abdominal wall bulge, whose clinical data were analyzed retrospectively. Results All the procedures were performed successfully, including 5 open operation and 2 laparoscopic repair. The mean operation time was 85 min (ranged 68 to 130 min). After operation, 1 seroma formation and 1 hemorrhage in the thoracic cavity developed and were cured with the conservative therapy. Mean postoperative hospital stay was 9.5 d (ranged 8 to 16 d). There was no recurrence, infection, or prolonged pain during 1－4 years follow-up. Conclusion Abdominal wall bulge is caused by the weakness of abdominal wall muscle, and the intraperitoneal onlay mesh repair with compound patch is an appropriate therapy.
ObjectiveTo observe the effect of compound chlorhexidine gargle wash care for patients after radical surgery of tongue cancer. MethodsBetween January 2013 and March 2014, 40 patients with tongue cancer who underwent radical surgery without radiation therapy or chemotherapy before operation were selected and randomly divided into compound chlorhexidine giuconatie gargle solution group (intervention group, n=19) and traditional oral care group (control group, n=21). Then we compared the two groups in terms of bacterial colony number, oral cavity cleanness, incidence rate of bad breath and oral ulcer. ResultsBefore intervention, there was no significant diTherences between the two groups in the number of bacterial colony, oral cavity cleanness or oral odor (P>0.05). After treatment, the bacterial colony number and incidence of oral ulcer in the intervenient group were significantly lower, and oral odor was slighter than that of the control group (P<0.05). Oral cavity cleanness between the two groups was not significantly different (P>0.05). ConclusionCompound chlorhexidine gargle wash care for patients after radical surgery of tongue cancer was better than the traditional treatment in terms of bacterial colony number, incidence rate of bad breath and oral ulcer. It is worth clinical popularizing.
OBJECTIVE: To investigate the effect of compound pattern of ceramic bovine bone (CBB) and hydrogel(HG) on attachment, proliferation and differentiation of bone marrow stromal cell (MSC), and to find out the best way of constructing tissue engineered bone. METHODS: CBB, HG and MSC was compounded in different patterns and sequences to form CBB/HG/MSC (group A), HG/MSC/CBB (group B), CBB/MSC/HA (group C) and CBB/MSC (control group). Attachment and morphology of MSC were observed by scanning electronic microscope; the proliferation of MSC was evaluated by cell count; alkaline phosphatase(ALP) activity was examined by histochemistry and type I collagen synthesis was examined by immunohistochemistry staining 5 and 10 days later. RESULTS: In group A, MSC spread better, and ALP activity of group A was significantly higher than that of group B and control group(P lt; 0.01); but there was no significant difference between group A and group C(P gt; 0.05). There was no significant difference in type I collagen synthesis between four groups on the 5th day; but mean gray scale of type I collagen in group B was significantly higher than that in the other groups on the 10th day(P lt; 0.01). CONCLUSION: Different compound patterns of CBB, HG and MSC affect attachment, proliferation, differentiation of MSC. The compound pattern of CBB/HG/MSC is better than the others.
Objective To evaluate the effect of nano-hydroxyapatit e collagen (nHAC) bone and marrow mesenchymal stem cells (MSCs) on the treatment of rabbit osteonecrosis of the femoral head (ONFH) defect. Methods From June to October 2004, animal models of ONFH defect were established i n 45 New Zealand rabbits. They were divided into 3 groups randomly:In group A, as the control group, defect was not filled with any implants; In group B with nHAC; In group C with nHAC+MSC. Imaging and histological observation were made 4, 8, 12 weeks after operation. Results group C had a better o steogenesis ability than group B and group A. group B had a better osteogenesis ability than group A. Obvious new bones and osteogenesis were observed in group C 4 weeks after operation. The defect areas in group C were almost repaired 12 weeks after operation. Conclusion nHAC has a better effect of o steoconduction and it is a superior material for repairing bone defect of ONFH a nd of great value in treating ONFH when compounded with MSCs.
ObjectiveTo assess the effectiveness of the sural fasciomyocutaneous perforator flap in repair of soft tissue defect in weight-bearing area of the foot. MethodsBetween January 2007 and September 2010, 19 patients with soft tissue defects in the weight-bearing area of the foot were treated with sural fasciomyocutaneous perforator flaps. The etiology was traffic accident in 16 patients and crush injury in 3 patients. The interval of injury and admission was 2 hours to 14 days. The size of defect ranged from 8 cm×6 cm to 26 cm×16 cm; the size of flap ranged from 7 cm×7 cm to 25 cm×12 cm. The donor sites were repaired by free skin graft. The flap survival was observed after operation, and the pain score and sensory recovery at the reci pient site were used to assess the effectiveness. ResultsThe flaps survived with satisfactory aesthetic and functional results in 18 cases. Partial flap necrosis was noted and second healing was achieved after spl it thickness skin grafting in 1 case. One case of delayed ulceration was also noted after 5 weeks, ulceration was successfully cured after wound care and avoidance of weightbearing for 2 weeks. All patients were followed up 9-25 months (mean, 14.1 months). The flaps had good appearance, without bulky pedicle. Superficial sensation and deep sensation were restored in 17 cases (89.4%) and 18 cases (94.7%) respectively at last follow-up. ConclusionSural fasciomyocutaneous perforator flap is a rel iable modality in heel reconstruction, having the advantages of low ulceration rate, good wear resistance, and good sensation recovery.
Objective To investigate the therapeutic effect of the chitosan/polyethylene glycols-succinate/ mitomycin C (CH/PEG-SA/MMC) film on epidural scarring tissues. Methods According to a specific proportion of respective materials, the film of CH/PEG-SA/MMC was developed under some condition. Thirty SD rats were selected and randomized into 6 groups with 5 rats in each group. A rat model of lumbar laminectomy was used. The amount of 20 mg of the CH film was implanted into the animals in group I, 20 mg of CH/PEG film in group II, 20 mg of CH/PEGSA film in group III, 0.05 mg/mL of the MMC soaking for 5 minutes in group IV, 20 mg of CH/PEG-SA/MMC film in group V, and nothing was done in group VI. Specimens were harvested 4 weeks after the above procedures and were then subjected to immunohistochemical and histological examinations to compare their therapeutic effects on epidural cicatricial tissues. Results All rats were in good conditions after operation, without gait abnormal ity, restlessness, infection and death. There was no significant difference among the 6 groups in the postoperative Rydell score (P lt; 0.05). The content of hydroxyprol ine in groups I, II, III, IV, V and VI was (0.570 8 ± 0.345 0), (0.728 6 ± 0.150 6), (0.553 4 ± 0.122 3), (0.313 3 ± 0.106 4), (0.261 9 ± 0.102 1)and (1.020 1 ± 0.120 6) μg/ mg, respectively. There was a significant difference between groups IV, V and groups I, II, III (P lt; 0.05), and there was significant difference between group VI and the rest 5 groups (P lt; 0.05). According to the histological observation, group V had less collagenous fiber parallel ing the dura mater, with few inflammatory cells infiltration, with few capillary vessels and no reaction of macrophages. Conclusion CH/PEG-SA/MMC films can effectively reduce the amount of Hyp in epidural scarring tissues after lumbar laminectomy and therefore is a good treating method in preventing scarring tissue adhesion.
Objective Dexamethasone (DXM) can regulate the balance of neutrophil and cytokine and enhance the ischemia-reperfusion tolerance of the skin flap; amlodipine besylate (AB) can selectively expand the peripheral blood vesselsand rel ieve the vascular smooth muscle spasm. To investigate the percutaneous penetration abil ity of DXM/AB compound gel and evaluate its effect on survival of ischemic skin flap. Methods Sodium carboxymethylcellulose was used to make blank gel, which was mixed in DXM, AB, azone (AZ), and progylene glycol (PG) respectively to make the compound gel containing 0.3%DXM/0.5%AB only (group D), the compound gel containing 3%AZ/2%PG, 3%AZ, and 2%PG (groups A, B, and C), the 0.3%DXM gel containing 3%AZ/2%PG (group E), the 0.5%AB gel containing 3%AZ/2%PG (group F). The accumulative penetration of DXM and AB in compound gel, 0.3%DXM gel, 0.5%AB gel through excised rat skin and its penetration within flap tissue were investigated by ultraviolet spectrophotometry. Fifty SD rats were selected to make 100 mm × 10 mm random flap at the back, and were randomly divided into 5 groups according to different gels which were used to treat flaps (n=10): compound gel group (group A1), 0.3%DXM gel group (group B1), 0.5%AB gel group (group C1), blank gel group (group D1), and peritoneal injection of DXM (5 mg/kg) and AB (2 mg/kg) (group E1). The survival area of ischemic random skin flap was measured on the 7th day by planimetry. Twenty-four SD rats were selected to make 100 mm × 10 mm random flap at the back, and were randomly divided into 2 groups (n=12). The accumulative penetration of DXM and AB within skin flap were also detected at 2 and 6 hours after appl ication of 2 g of compound gel containing 3%AZ/2%PG (group A2) and peritoneal injection AB (2 mg/kg) / DXM (5 mg/kg) (group B2). Results The accumulative penetration of DXM and AB in compound gel were increased in time-dependent manner (P lt; 0.05), and it was the highest in group A, and was significantly higher than that in group B and group C (P lt; 0.01), but there was no significant difference when compared with group E or group F (P gt; 0.05). The accumulative penetration of DXM and AB in groups A, B, and C were significant higher than that in group D (P lt; 0.05). After 7 days, the survival area of flaps in groups A1, B1, C1, D1, and E1 were (695.0 ± 4.6), (439.3 ± 7.1), (477.5 ± 14.5), (215.2 ± 3.8), and (569.4 ± 9.7) mm2, respectively; group A1 was significantly higher than other groups (P lt; 0.05). After 2 and 6 hours, the quantities of DXM and AB in skin flap of group A2 were significantly higher than that of group B2 (P lt; 0.05). Conclusion In 0.3%DXM/0.5%AB compound gel, DXM and AB might penetrate into skin tissue, which could significantly increase the survivalarea of ischemic skin flap.
Targeting p21-activated kinase 1 (PAK1) is a novel strategy for pancreatic cancer treatment. Compound Kushen injection contains many anti-pancreatic cancer components, but the specific targets are unknown. In this study, 14α-hydroxymatrine, an active component of Kushen injection, was found to possess high binding free energy with the allosteric site of PAK1 by molecular docking based virtual screening. Molecular dynamics simulations suggested that 14α-hydroxymatrine caused the α1 and α2 helices of the allosteric site of PAK1 to extend outward to form a deep allosteric regulatory pocket. Meanwhile, 14α-hydroxymatrine induced the β-folding region at the adenosine triphosphate (ATP)-binding pocket of PAK1 to close inward, resulting in the ATP-binding pocket in a “semi-closed” state which caused the inactivation of PAK1. After removal of 14α-hydroxymatrine, PAK1 showed a tendency to change from the inactive conformation to the active conformation. We supposed that 14α-hydroxymatrine of compound Kushen injection might be a reversible allosteric inhibitor of PAK1. This study used modern technologies and methods to study the active components of traditional Chinese medicine, which laid a foundation for the development and utilization of natural products and the search for new treatments for pancreatic cancer.
In order to solve the difficult problems of repair and reconstruction for severe deep burns with compound tissue defects of upper limb, 26 cases were treated with transplantation of compound tissue flap, vascularized by anastomosis of blood vessel or by vascular pedicle. Several kinds of reparative and reconstructive procedure could be performed simultaneously. Not only the tissue defect was repaired, but also the upper limb function was reconstructed in one stage operation. Owing to the presence of abundant vascular supply from the vascularized compound tissue and primarily closing the wounds, the anti-infection potency was high, then it was suitable for such conditions as fresh severe deep burn with infection and compound tissue defects. As a result, this technique provided the best chance to save upper limb from amputation. The duration required for treatment could be markedly shortened. All the cases successed. The long-term functional recovery was satisfactory. This method provided the possibility to solve effectively the difficult problem dealing with the severe deep burns with compound tissue defects of upper limb.