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Acupuncture is ineffective for chronic low back pain? A critical analysis and rethinking
Xuqiang Wei, Baoyan Liu
《医学前沿(英文)》 2021年 第15卷 第5期 页码 767-775 doi: 10.1007/s11684-020-0785-6
关键词: chronic low back pain sham acupuncture acupuncture methodology therapeutic evaluation
Factors related to compliance with oral analgesic treatment of inpatients with chronic pain
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《医学前沿(英文)》 2015年 第9卷 第3期 页码 374-379 doi: 10.1007/s11684-015-0411-1
This study aimed to determine the relationship between the different factors of analgesic therapy and the compliance of chronic pain inpatients. We prospectively investigated 100 consecutive inpatients with non-cancer chronic pain who were hospitalized to receive oral analgesic treatment in the Pain Department of West China Hospital from May 2013 to October 2013. Patients who completed the treatment plan were recorded as good compliance, whereas patients who partly completed or even refused the treatment were recorded as moderate or non-compliance, respectively. A total of 73 (73.7%), 17 (17.1%), and 9 (9.2%) patients showed good, moderate, and non-compliance, respectively. Univariate analyses showed significantly better compliance among farmers, patients educated in college or above, with family income of<3000 CNY, and with severe or moderate pain than those employed and unemployed (P=0.02), patients educated below college (P=0.013), with family income of≥3000 CNY (P=0.025), and with mild pain (P<0.001), respectively. Logistic regression analysis showed that the family income of≥3000 CNY (OR: 2.50, 95%CI: 1.65–4.51, P=0.021) and mild pain (OR: 1.27, 95%CI: 1.03–3.31, P=0.016) were associated with moderate or non-compliance with oral analgesic treatment. In conclusion, the low compliance with oral treatment of analgesics was found in Chinese inpatients with chronic pain and compliance was negatively associated with family income and degree of pain of patients.
Efficacy and safety of perioperative parecoxib for acute postoperative pain treatment in children: a
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《医学前沿(英文)》 2015年 第9卷 第4期 页码 496-507 doi: 10.1007/s11684-015-0414-y
Perioperative parecoxib administration reduces postoperative pain, opioid consumption, and adverse events in adult patients. However, the efficacy and safety of parecoxib in children remain unclear. This meta-analysis included related published studies to address this concern. Eight databases in the literature until February 2015 were systematically explored to identify randomized controlled trials (RCTs) comparing perioperative parecoxib administration and placebo/standard treatments for acute postoperative pain in children. Primary outcomes were postoperative pain scores and adverse events. The Face, Legs, Activity, Crying, Consolability scale was used to score pain in children younger than 6 years, whereas the Visual Analog Scale was used in children older than 6 years. Secondary outcomes were sedation scores (measured using the Ramsay scale), agitation scores (measured using the Sedation-Agitation Scale), and opioid consumption. The methodological quality of RCTs was independently assessed in accordance with the “Risk of bias” of Cochrane Collaboration. Data were analyzed using Review Manager 5.2. Twelve RCTs involving 994 patients met the inclusion criteria. Compared with children who received placebo treatment, those who received parecoxib demonstrated lower early (2 h) and later (12 h) postoperative pain scores; lower incidence rates of postoperative nausea, vomiting, and agitation; higher early (1 h) postoperative sedation scores; and lower agitation scores. Similarly, children who received parecoxib had lower early (2 h) and later (12 h) postoperative pain scores, lower incidence rates of postoperative nausea and vomiting, and lower early (1 h) postoperative sedation scores compared with those who received standard treatments; however, these children showed no significant difference in agitation scores. Unfortunately, data on the effect of parecoxib on opioid consumption were insufficient. Overall, these results suggested that perioperative parecoxib administration was associated with less acute postoperative pain and fewer adverse events compared with placebo or standard treatments. Parecoxib administration also resulted in less emergence agitation compared with placebo treatment and less excessive sedation concern compared with standard treatments. However, the long-term effects, effects on opioid consumption, and patient satisfaction of parecoxib administration warrant further investigation.
关键词: NSAID cyclooxygenase 2 inhibitor child pain postoperative opioid placebo
New perspective on the natural course of chronic HBV infection
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《医学前沿(英文)》 2014年 第8卷 第2期 页码 129-134 doi: 10.1007/s11684-014-0339-x
Chronic hepatitis B virus (HBV) infection is a significant threat to public health and an enormous burden on society. Mechanisms responsible for chronic HBV infection remain poorly understood. A better understanding of the natural course of chronic HBV infection may shed new light on the mechanisms underlying this disease and help in designing new antiviral strategies. Natural course of chronic HBV infection is conventionally viewed as an uninterrupted process that is usually marked by HBV e antigen (HBeAg) seroconversion or characterized by different phases associated with assumed host responses to HBV infection. However, none of these descriptions captures or highlights the core events that determine the natural course of chronic HBV infection. In this review, we briefly present the current knowledge on this subject and explain the significance and implication of events that occur during infection. A pre-core mutant becomes predominant in the viral population following elimination of the wild-type virus in duck hepatitis B virus-chronically infected animals. The coupled events in which first there is viral clearance that clears wild-type virus and then there is the reinfection of wild-type virus cleared livers with mutant virus are highly relevant to understanding of the natural course of chronic HBV infection under both treated and untreated conditions. In our new perspective, a general natural course of chronic HBV infection comprises cycles of viral clearance and reinfection, and such cycles prolong the chronic HBV infection course. Reviewing published data on the natural course of chronic HBV infection can reduce the possibility of missing important points in the initial data interpretation.
关键词: hepatitis B virus chronic HBV infection natural course hepatitis B seroconversion
Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidney
YU Xiaofang, XU Xialian, YE Zhibin
《医学前沿(英文)》 2007年 第1卷 第3期 页码 308-311 doi: 10.1007/s11684-007-0059-6
Vaccine therapies for chronic hepatitis B: can we go further?
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《医学前沿(英文)》 2014年 第8卷 第1期 页码 17-23 doi: 10.1007/s11684-014-0313-7
Chronic hepatitis B is a major health burden worldwide. In addition to the recent progress in antiviral treatment, therapeutic vaccination is a promising new strategy for the control of chronic hepatitis B. On the basis of the major specific and non-specific immune dysregulations and defects in chronic hepatitis B patients, this paper presents the peptide and protein-based, DNA-based, cell-based, and antigen-antibody-based therapeutic vaccines, which have undergone clinical trials. The advantages, disadvantages, and future perspectives for these therapeutic vaccines are discussed.
关键词: chronic hepatitis B therapeutic antigen-antibody complexes DNA vaccine
Perceived resource support for chronic illnesses among diabetics in north-western China
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《医学前沿(英文)》 2016年 第10卷 第2期 页码 219-227 doi: 10.1007/s11684-016-0441-3
A high level of social support can improve long-term diabetes self-management. Support from a single source has been evaluated. This study aims to analyze support from multiple and multilevel sources for diabetic patients by using the Chronic Illness Resources Survey (CIRS). Factors influencing the utilization of the CIRS were also evaluated. A total of 297 patients with diabetes were investigated using the CIRS and Perceived Diabetes Self-management Scale in Shihezi City, China. Descriptive statistics were used to explain demographic variables and scores of the scales. Factors affecting the utilization of chronic illness resources were determined through univariate analysis and then examined by multivariate logistic regression analysis. Of the 297 diabetic patients surveyed, 67% failed to reach the standard (more than 3 points) of utilizing chronic illness resources. Moreover, utilization of chronic illness resources was positively moderately correlated with self-management of diabetes (r = 0.75, P <0.05). According to the multivariate logistic regression analysis, age (OR, 3.42; 95%CI, 1.19–9.84) and monthly income (OR, 5.27; 95%CI, 1.86–14.90) were significantly positively associated with the CIRS score. Individuals with high school (OR, 2.61; 95%CI, 1.13–6.05) and college (OR, 3.02; 95%CI, 1.13–8.04) degrees obtained higher scores in the survey than those with elementary school education. Results indicated that utilization of resources and support for chronic illness self-management, particularly personal adjustment and organization, were not ideal among diabetics in the communities of north-western China. Improved utilization of chronic illness resources was conducive for proper diabetes self-management. Furthermore, the level of utilization of chronic illness resources increased with age, literacy level, and monthly income.
关键词: chronic illness resources survey diabetes community north-western China
Correlation between viral load and liver cirrhosis in chronic hepatitis B patients
Lili LIU MM , Jiyao WANG MD , Weimin SHE MM ,
《医学前沿(英文)》 2009年 第3卷 第3期 页码 271-276 doi: 10.1007/s11684-009-0054-1
Advances in some common chronic liver diseases
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《医学前沿(英文)》 2014年 第8卷 第2期 页码 127-128 doi: 10.1007/s11684-014-0341-3
Overview on acute-on-chronic liver failure
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《医学前沿(英文)》 2016年 第10卷 第1期 页码 1-17 doi: 10.1007/s11684-016-0439-x
Liver failure (LF) is defined as severe dysfunction in hepatic synthesis, detoxification, and metabolism induced by various etiologies. Clinical presentation of LF typically includes severe jaundice, coagulation disorder, hepatic encephalopathy, and ascites. LF can be classified into acute LF, acute-on-chronic LF (ACLF), and chronic LF. ACLF has been demonstrated as a distinct syndrome with unique clinical presentation and outcomes. The severity, curability, and reversibility of ACLF have attracted considerable attention. Remarkable developments in ACLF-related conception, diagnostic criteria, pathogenesis, and therapy have been achieved. However, this disease, especially its diagnostic criteria, remains controversial. In this paper, we systemically reviewed the current understanding of ACLF from its definition, etiology, pathophysiology, pathology, and clinical presentation to management by thoroughly comparing important findings between east and west countries, as well as those from other regions. We also discussed the controversies, challenges, and needs for future studies to promote the standardization and optimization of the diagnosis and treatment for ACLF.
关键词: liver failure chronic liver failure acute-on-chronic liver failure diagnosis prognosis treatment
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《医学前沿(英文)》 2015年 第9卷 第3期 页码 304-311 doi: 10.1007/s11684-015-0400-4
In the tyrosine kinase inhibitor (TKI) era, imatinib is the first-line therapy for patients with chronic myeloid leukemia (CML) in chronic or accelerated phase. Although second-generation TKIs (TKI2), including dasatinib and nilotinib, are appropriate treatment regimens for patients with disease that progressed to accelerated phase following imatinib therapy, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curative therapy. This study retrospectively analyzed the efficacy of TKI2 and HSCT for treatment of CML in accelerated phase. Ninety-three patients with CML registered in the Chinese CML alliance database from February 2001 to February 2014 were enrolled and divided into the TKI2 (n?=?33) and allo-HSCT (n?=?60) groups. In the TKI2 group, 26 and 7 patients received nilotinib and dasatinib, respectively, as initial TKI2 and 11 patients transferred to the alternative TKI2 after failure to one TKI2. In the allo-HSCT group, 22 (36.7%), 35 (58.3%), and 3 (10%) patients underwent allo-HSCT from an HLA-matched sibling donor, HLA mismatched/haploidentical donor, and unrelated donor, respectively. All patients in the HSCT group were engrafted. Overall, 69.7%, 48.5%, and 45.5% of patients presented hematological, cytogenetic, and major molecular responses, respectively, to at least one of TKI2. All 60 patients (100%) achieved CHR and cytogenetic response in the HSCT group. Patients in the TKI2 group exhibited lower 5-year overall survival rate (42.9% vs. 86.4%, P = 0.002), 5-year event-free survival rate (14.3% vs. 76.1%, P<0.001), and 5-year progression-free survival (28.6% vs. 78.1%, P<0.001) than those in the allo-HSCT group. Multivariate analysis showed that male sex and TKI2therapy were predictors of poor overall survival, whereas hemoglobin<100 g/L and TKI2 therapy were predictors of poor event-free survival and progression-free survival. These results indicated that allo-HSCT may be superior to nilotinib and dasatinib for adult patients with CML in accelerated phase.
关键词: chronic myeloid leukemia imatinib dasatinib nilotinib allogeneic hematopoietic stem cell transplantation
Chronic hepatitis B virus infection: epidemiology, prevention, and treatment in China
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《医学前沿(英文)》 2014年 第8卷 第2期 页码 135-144 doi: 10.1007/s11684-014-0331-5
Chronic hepatitis B is a major health problem in China. The universal vaccination program since 1992 has changed the epidemiology of hepatitis B virus infection in China from highly to moderately endemic. The most prevalent hepatitis B virus strains in China are genotypes B and C, whereas those in western provinces are genotypes D and C/D hybrid. Chronic hepatitis B poses a heavy burden to the society in China. Different treatment strategies have been explored to improve patient outcomes in a cost-effective manner. However, antiviral drugs with a low genetic barrier to resistance are still extensively used because of the generally low income and limited resources in China. Individualized antiviral therapy is closely associated with translational medicine, which utilizes information from studies on genomics, immune biomarkers, and fibrosis. The results of these studies are crucial in further improving treatment outcomes.
The role of RAS effectors in BCR/ABL induced chronic myelogenous leukemia
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《医学前沿(英文)》 2013年 第7卷 第4期 页码 452-461 doi: 10.1007/s11684-013-0304-0
BCR/ABL is the causative agent of chronic myelogenous leukemia (CML). Through structure/function analysis, several protein motifs have been determined to be important for the development of leukemogenesis. Tyrosine177 of BCR is a Grb2 binding site required for BCR/ABL-induced CML in mice. In the current study, we use a mouse bone marrow transduction/transplantation system to demonstrate that addition of oncogenic NRAS (NRASG12D) to a vector containing a BCR/ABLY177F mutant “rescues” the CML phenotype rapidly and efficiently. To further narrow down the pathways downstream of RAS that are responsible for this rescue effect, we utilize well-characterized RAS effector loop mutants and determine that the RAL pathway is important for rapid induction of CML. Inhibition of this pathway by a dominant negative RAL is capable of delaying disease progression. Results from the present study support the notion of RAL inhibition as a potential therapy for BCR/ABL-induced CML.
Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype
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《医学前沿(英文)》 2013年 第7卷 第4期 页码 425-432 doi: 10.1007/s11684-013-0295-x
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality throughout the world and is mainly characterized by persistent airflow limitation. Given that multiple systems other than the lung can be impaired in COPD patients, the traditional FEV1/FVC ratio shows many limitations in COPD diagnosis and assessment. Certain heterogeneities are found in terms of clinical manifestations, physiology, imaging findings, and inflammatory reactions in COPD patients; thus, phenotyping can provide effective information for the prognosis and treatment. However, phenotypes are often based on symptoms or pathophysiological impairments in late-stage COPD, and the role of phenotypes in COPD prevention and early diagnosis remains unclear. This shortcoming may be overcome by the potential genotypes defined by the heterogeneities in certain genes. This review briefly describes the heterogeneity of COPD, with focus on recent advances in the correlations between genotypes and phenotypes. The potential roles of these genotypes and phenotypes in the molecular mechanisms and management of COPD are also elucidated.
关键词: chronic obstructive pulmonary disease heterogeneity phenotype genotype prediction
Mechanism of arterial remodeling in chronic allograft vasculopathy
Qichang Zheng, Shanglong Liu, Zifang Song
《医学前沿(英文)》 2011年 第5卷 第3期 页码 248-253 doi: 10.1007/s11684-011-0149-3
关键词: transplantation chronic rejection neointimal immunology arterial remodeling allograft vasculopathy
标题 作者 时间 类型 操作
Acupuncture is ineffective for chronic low back pain? A critical analysis and rethinking
Xuqiang Wei, Baoyan Liu
期刊论文
Factors related to compliance with oral analgesic treatment of inpatients with chronic pain
null
期刊论文
Efficacy and safety of perioperative parecoxib for acute postoperative pain treatment in children: a
null
期刊论文
Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidney
YU Xiaofang, XU Xialian, YE Zhibin
期刊论文
Correlation between viral load and liver cirrhosis in chronic hepatitis B patients
Lili LIU MM , Jiyao WANG MD , Weimin SHE MM ,
期刊论文
allogeneic hematopoietic stem cell transplantation to nilotinib and dasatinib for adult patients with chronic
null
期刊论文