Zhang Z.,Yidu Central Hospital of Weifang |
Chen J.,Zhejiang Provincial Hospital of Traditional Chinese Medicine
Medicine (United States) | Year: 2016
Background: The study aimed to compare the effectiveness and safety of topical versus intravenous (IV) tranexamic acid (TXA) for reducing blood loss in primary total hip arthroplasty (THA). Methods: This systematic review and meta-analysis were performed according to the preferred reporting items for systematic reviews and meta-analyses statement criteria. PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedicine Literature (CBM), Wanfang Database, China National Knowledge Infrastructure (CNKI), and Google Scholar were searched for randomized controlled trials (RCTs) and non-RCTs that compare topical versus IV-TXA administration for reducing blood loss during TKA from their inception to February, 2016. Meta-analysis was performed by Stata 12.0 software. Results: Seven studies comprising 2056 patients were included in this meta-analysis. No significant difference is found between topical TXA groups and IV-TXA groups regarding transfusion requirements (RR=1.37, 95% confidence interval [CI]: 0.96-1.97, P=0.083), total blood loss (MD 17.09, 95% CI: 33.74-67.91, P=0.510), and hemoglobin decline (MD 0.32, 95%CI: 0.04-0.69, P=0.122). Meanwhile, there is no significant difference in terms of the occurrence of deep venous thrombosis (RR= 1.09, 95% CI: 0.40-3.90, P=0.869). Conclusion: Topical TXA has a similar efficacy to IV-TXA in reducing both blood loss and transfusion rate without sacrificing safety in primary THA. Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All.
Zhai L.,Tongde Hospital of Zhejiang Province |
Song Z.,Zhejiang Provincial Hospital of Traditional Chinese Medicine |
Liu K.,Zhejiang University
Medicine (United States) | Year: 2016
The purpose of this systematic review and meta-Analysis of randomized controlled trials (RCTs) and non-RCTs was to evaluate the efficacy and safety of gabapentin versus placebo for pain control after total knee arthroplasty (TKA). In December 2015, a systematic computer-based search was conducted in the Medline, Embase, PubMed, Cochrane Controlled Trials Register (CENTRAL), Web of Science, Google, and Chinese Wanfang databases. This systematic review and meta-Analysis were performed according to the preferred reporting items for systematic reviews and meta-Analyses (PRISMA) statement criteria. The primary endpoint was the visual analogue scale (VAS) score after TKA with rest or mobilization at 24 and 48hours, representing the efficacy of pain control after TKA. Cumulative morphine consumption via patient controlled anesthesia (PCA) was also assessed to determine the morphine-spare effect. Complications such as dizziness, pruritus, vomiting, nausea, and sedation were also compiled to assess the safety of gabapentin. Stata 12.0 software was used for the meta-Analysis. After testing for publication bias and heterogeneity across studies, the data were aggregated for random-effects modeling whenever necessary. Six studies involving 769 patients met the inclusion criteria. Our meta-Analysis revealed that gabapentin resulted in superior pain relief compared to the control group in terms of VAS score with rest at 24hours (mean difference [MD]=-3.47; 95% confidence interval [CI]-6.16 to-0.77; P=0.012) and at 48hours postoperatively (MD=-2.25; 95% CI-4.21 to-0.30; P=0.024). There was no statistically significant difference between the groups with respect to the VAS score at 24hours postoperatively (MD=1.05; 95% CI-3.31 to 5.42; P=0.636) or at 48hours (MD=1.71; 95% CI-0.74 to 4.15; P=0.171). These results indicated that the perioperative administration of gabapentin decreases the cumulative morphine consumption via PCA at 24hours (MD=-8.28; 95% CI-12.57 to-3.99; P=0.000) and 48hours (MD=-4.50; 95% CI-10.98 to-3.61; P=0.221). Furthermore, gabapentin decreased the rate of postoperative dizziness (relative risk [RR], 0.68; 95% CI 0.47-0.99, P=0.044) and the occurrence of pruritus (RR, 0.50; 95% CI 0.37-0.67, P=0.000). Based on the current meta-Analysis, gabapentin exerts an analgesic and opioid-sparing effect in acute postoperative pain management without increasing the rate of dizziness and pruritus. © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Tong P.,Zhejiang Chinese Medical University |
Tong P.,Zhejiang Provincial Hospital of Traditional Chinese Medicine |
Wu C.,Zhejiang Chinese Medical University |
Wang X.,Wenzhou Hospital of Traditional Chinese Medicine |
And 6 more authors.
Journal of Ethnopharmacology | Year: 2013
Ethnopharmacological relevance: Fuzi (lateral root of Aconitum carmichaeli) is a popular traditional Chinese medicine well known for its both therapeutic and high-toxic activities. Its toxic alkaloid ingredients, mainly aconitine, mesaconitine, and hypaconitine, are responsible for the high toxicity. However, to date, no detoxication strategy is available to completely eliminate Fuzi's toxicity, and, whether Fuzi's efficacy could be kept after detoxication, remain unknown and debatable. Materials and methods: The purpose of this study was to establish and validate a complete-detoxication strategy for Fuzi via acute toxicity test, to clarify the detoxication mechanism by HPLC and titrimetric analyses, and to evaluate the therapeutic effect of detoxicated Fuzi on adjuvant arthritis (AA). Three processed Fuzi (Bai-fu-pian) with 30-min, 60-min, and 120-min decoctions, respectively, named dBfp-30, dBfp-60, and dBfp-120, were prepared for this study. For the acute toxicity test, their oral doses to male and female Kunming mice were up to 70-190 g/kg body weight, and their toxicological profiles were evaluated by median lethal dose (LD50), maximal tolerance dose (MTD), minimal lethal dose (MLD), no-observed-adverse- effect-level (NOAEL), and time-concentration-mortality (TCM) modeling methods using a 14-day schedule with up to five doses. The HPLC analysis was performed to determine the detoxication-induced changes in composition and amount of aconitine, mesaconitine and hypaconitine in Fuzi, whilst the titrimetric method was adopted to estimate the amount changes of Fuzi's total alkaloids. AA model was established by incomplete Freund's adjuvant injection in Wistar rats, and the animal's physiological (body weight, food intake, etc.), clinical (hind paw volume), and immunological (IL-1 and TNF-α) parameters were assessed as markers of inflammation and arthritis. Results: With increasing decoction time, the acute toxicity of detoxicated Fuzi became decreased in the following order: dBfp-30 (LD50 of 145.1 g/kg; MTD of 70 g/kg; MLD of 100 g/kg; NOAEL of 70 g/kg) >dBfp-60 (too large LD50; MTD of 160 g/kg; MLD of 190 g/kg; NOAEL of 100 g/kg) >dBfp-120 (no LD50; unlimited MTD; unlimited MLD; NOAEL of 130 g/kg). dBfp-30 and dBfp-60 displayed the toxicity at a dose-dependent manner with maximum mortalities reaching 100% and 50% respectively, whereas no mortality or signs of intoxication was induced by dBfp-120. The chemical analyses revealed a dramatic reduction of the toxic alkaloids as well as total alkaloids in Fuzi after the detoxication, from which no level of aconitine and only minimum residual of mesaconitine (0.56±0.02 μg/g) and hypaconitine (8.73±0.13 μg/g) were detected in dBfp-120. However, no significant difference of total alkaloid amount was found among dBfp-30, dBfp-60, and dBfp-120 (P>0.05), suggesting an equivalent conversion from toxic alkaloids to its non-toxic derivants in dBfp-120. Further, also no significant differences were seen among dBfp-30, dBfp-60, and dBfp-120 for the therapeutic effects on physiological, clinical, and immunological parameters in AA rat, indicating that dBfp-120 is of non-toxicity and efficacy. Conclusions: A complete-detoxication strategy has been developed successfully for ensuring the safe and effective use of Fuzi. The detoxication mechanism associated with elimination of toxic alkaloids has kept Fuzi's efficacy, indicating a non-interdependent relationship between its efficacy and toxicity. This is the first report on such an optimal detoxication strategy and on the application of detoxicated Fuzi in AA. It may provide in depth understanding to the toxicological and pharmacological profiles of Fuzi and further benefit the herbal drug development with safety and efficacy for disease especially RA therapy. © 2013 Elsevier Ireland Ltd.
PubMed | Taizhou Hospital, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Chinese Medicine Hospital of Hangzhou, Jinhua Municipal Central Hospital and 9 more.
Type: Journal Article | Journal: Journal of diabetes investigation | Year: 2016
Lifestyle management helps improve the clinical outcome of patients with type2 diabetes. The present study aimed to obtain lifestyle data on the dietary and physical activity of adult type2 diabetes patients in Zhejiang province of eastern China for better patient education and improvement of clinical management.A cross-sectional survey of 607 adult type2 diabetes patients was carried out in 12 hospitals within eight cities of Zhejiang province. Data were collected for sex, age, basic physical measurement (blood pressure, height, weight, waist circumference and hip circumference), dietary favor and habit (vegetarian diets vs meat diets, preference of salty or light flavors), detailed dietary intake (24-h recall method), as well as the weekly physical activity.The mean age of the patients in the analysis was 56.3912.29years, and 38.71% of the patients had higher levels of body mass index than recommended. The average daily total energy intake was 1887.71575.10kcal. The percentage of calories from carbohydrate, protein and fat were 61.3611.59%, 13.293.37% and 25.3511.16%, respectively. For physical activity, the patients generally spent most of their daily time sitting and sleeping, and the time for moderate vigorous activity was limited.Adult patients with type2 diabetes in Zhejiang province have a relatively high carbohydrate and low protein diet, with very limited physical activity. Patient education to achieve a better lifestyle intervention needs to improve in this region.
PubMed | Wenzhou University and Zhejiang Provincial Hospital of Traditional Chinese Medicine
Type: Journal Article | Journal: Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine | Year: 2016
Researches indicate that the dysregulation of microRNA (miRNA) is involved in tumorigenesis. Among such dysregulated miRNAs in cancer, miR-145 is reported to be downregulated in multiple cancers. In this study, we demonstrated the downregulation of miR-145 in triple-negative breast cancer (TNBC) tissues and TNBC cell lines by quantitative reverse-transcription polymerase chain reaction (RT-PCR) analysis. Furthermore, we found that the tumor necrosis factor-alpha (TNF-)-induced apoptosis was expanded by the transfection of miR-145 in MDA-MB-231 which belongs to the TNBC cell lines. We then indicated that the mechanism by which miR-145 promotes the TNF--induced apoptosis is dependent on the formation of RIP1-FADD-caspase-8 complex. The cellular inhibitor of apoptosis (cIAP1), which is the inhibitor of apoptosis protein, was found to be a target of miR-145 in MDA-MB-231 cells. As a result of cIAP1 overexpression, the promotion of miR-145 on TNF--induced apoptosis was inhibited in MDA-MB-231 cells. Therefore, our results indicate that miR-145 acts as a tumor suppressor in TNBC, suggesting that the miR-145-cIAP1 axis might be a potential therapeutic target for TNBC.
Xie X.-H.,Zhejiang Provincial Hospital of Traditional Chinese Medicine |
Zhao H.,Zhejiang Provincial Hospital of Traditional Chinese Medicine |
Hu Y.Y.,Zhejiang Provincial Hospital of Traditional Chinese Medicine |
Gu X.D.,Zhejiang Provincial Hospital of Traditional Chinese Medicine
Experimental and Therapeutic Medicine | Year: 2014
Multidrug resistance (MDR) is a major obstacle to the chemotherapeutic treatment of breast cancer. Germacrone, the main component of Rhizoma Curcuma, has been shown to possess antitumor, anti‑inﬂammatory and immunomodulatory properties. The aim of the present study was to investigate the effect of germacrone on MCF‑7/Adriamycin (ADR) multidrug‑resistant human breast cancer cells. The treatment of MCF‑7/ADR cells with a combination of germacrone and ADR resulted in an increase in cytotoxicity compared with that of ADR alone, as determined using an MTT assay. Flow cytometric analysis revealed that germacrone promoted cell apoptosis in a dose‑dependent manner, whilst treatment with germacrone plus ADR enhanced the apoptotic effect synergistically. Furthermore, the results from the western blot analysis demonstrated that augmenting ADR treatment with germacrone resulted in a reduction of anti‑apoptotic protein expression levels (bcl‑2) and enhancement of pro‑apoptotic protein expression levels (p53 and bax) in MCF‑7/ADR cells compared with the levels achieved by treatment with ADR alone. In addition, germacrone significantly reduced the expression of P‑glycoprotein via the inhibition of the multidrug resistance 1 (MDR1) gene promoter. These findings demonstrate that germacrone has a critical role against MDR and may be a novel MDR reversal agent for breast cancer chemotherapy. © 2014, Spandidos Publications. All rights reserved.
Zhou J.G.,Zhejiang Provincial Hospital of Traditional Chinese Medicine
Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences | Year: 2011
To determine the role of the novel proinflammatory cytokine high mobility group box chromosomal protein 1 (HMGB-1) in the pathogenesis of lupus nephritis. Serum levels of anti-dsDNA antibodies were determined by enzyme linked immunosorbent assay (ELISA). Renal morphologic features were examined by light microscopy, electron microscopy, and immunohistologic analyses. The mRNA expression of HMGB-1 and monocyte chemoattractant protein-1 (MCP-1) was detected by RT-PCR. MRL/lpr mice demonstrated characteristic alterations of serum immune parameters, with progressively increased anti-dsDNA antibodies with age, compared with age-matched C57BL/6J mice. MRL/lpr mice showed progressive development of renal damage, starting at 12 weeks of age and reached the peak at 20 weeks. The observed lesions included the presence of enlarged hypercellular glomeruli, with increased numbers of both resident cells and infiltrating leukocytes. Higher expression of HMGB-1 mRNA was found in MRL/lpr mice than what in C57BL/6J mice. Expression of HMGB-1 was positively correlated with that of MCP-1 mRNA. The results demonstrate that the higher expression of HMGB-1 may contribute to the pathogenesis of lupus nephritis.
Jin C.,Zhejiang University |
Liang R.,Zhejiang Provincial Hospital of Traditional Chinese Medicine
Journal of Obstetrics and Gynaecology Research | Year: 2015
Aim AKT signaling regulates multiple biological processes and expresses in various cancers. miR-205 plays complex roles in tumorigenesis and tumor progression by acting either as a tumor suppressor or an oncogene depending on the tumor type. Here we describe the molecular mechanism of miR-205 regulating epithelial-mesenchymal transition by activation of AKT signaling in endometrial cancer cells HEC-50B and HEC-1-A. Material and Methods The proliferation of HEC-50B cells transfected with miR-205 mimic was assessed by WST-1 assay. The migration and invasion were evaluated by BD transwell migration and matrigel invasion assays. The EMT markers were detected by Western blot. Results We found that miR-205 increased the proliferation in HEC-50B cells. The migration and invasion of HEC-50B cells and HEC-1-A cells were enhanced by miR-205. When HEC-50B cells and HEC-1-A cells were treated with anti-miR-205 inhibitor, the migration and invasion were decreased as compared with the negative control. The overexpression of miR-205 inhibited E-cadherin expression and promoted Snail expression by activation of AKT and downregulation of glycogen synthase kinase 3β. However, after the HEC-50B cells and HEC-1-A cells were treated with anti-miR-205 inhibitor, E-cadherin expression was increased and Snail protein level was decreased by inhibition of AKT expression. Conclusion Our data strongly suggest that miR-205 plays an important role in endometrial cancer migration and invasion by targeting the AKT pathway. Our data highlight miR-205 as a potential molecular target for endometrial cancer treatment. © 2015 Japan Society of Obstetrics and Gynecology.
PubMed | Central South University and Zhejiang Provincial Hospital of Traditional Chinese Medicine
Type: Journal Article | Journal: Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society | Year: 2016
This study investigates the effect of a new Chinese massage technique named press-extension on degenerative lumbar with disc herniation and facet joint dislocation, and provides a biomechanical explanation of this massage technique. Self-developed biomechanical software was used to establish a normal L1-S1 lumbar 3D FE model, which integrated the spine CT and MRI data-based anatomical structure. Then graphic technique is utilized to build a degenerative lumbar FE model with disc herniation and facet joint dislocation. According to the actual press-extension experiments, mechanic parameters are collected to set boundary condition for FE analysis. The result demonstrated that press-extension techniques bring the annuli fibrosi obvious induction effect, making the central nucleus pulposus forward close, increasing the pressure in front part. Study concludes that finite element modelling for lumbar spine is suitable for the analysis of press-extension technique impact on lumbar intervertebral disc biomechanics, to provide the basis for the disease mechanism of intervertebral disc herniation using press-extension technique.
PubMed | Zhejiang Provincial Hospital of Traditional Chinese Medicine and Zhejiang University
Type: Journal Article | Journal: Oncology letters | Year: 2016
It is well known that radioactive rays may cause damage to the human body. Progress in modern medicine has led to an increased risk of therapeutic and diagnostic radiation exposure of patients. Although clear evidence of a radiation dose-dependent risk of chronic myeloid leukaemia, particularly for patients exposed to radiation at a young age, has been established, it is not known whether radiation exposure during diagnostic imaging also increases the risk of cancer. The present study reports the case of a patient who underwent several diagnostic imaging tests (including repeated chest radiography and computed tomography) for recurrent pneumothorax. At around one year subsequent to these tests, the patient was diagnosed with chronic myeloid leukaemia. The patient exhibited an increase in white blood cell count over time, and a bone marrow smear test showed a myeloid/erythroid ratio of 13.9:1. In addition, the qualitative breakpoint cluster region (BCR)/Abelson (ABL) gene test revealed positive results for BCR/ABL fusion (p210). Based on the data reported in the current case, research aimed at elucidating the potential risks associated with diagnostic radiation is urgently required. It is crucial that medical professionals consider the potential harmful side effects of diagnostic radiation when ordering radiation-based diagnostic imaging examinations.