ObjectiveTo analyze the correlation of thrombopoietin (TPO) and anti-TPO antibody with thrombocytopenia in patients with primary Sj?gren syndrome (PSS). MethodsWe included in our study 40 PSS patients with thrombocytopenia (group A), 22 PSS patients who once had thrombocytopenia and returned to normal (group B), 40 PSS patients with normal platelet counts (group C) and 40 healthy controls (group D) between September 2013 and October 2014. Anti-TPO antibody was detected by indirect enzyme-linked immunosorbent assay (ELISA), and serum TPO levels were measured by ELISA. We analyzed the relationship between the assay results and the clinical manifestations and parameters. ResultsThe serum TPO levels in groups A, B, and C were (129.74±17.47) , (330.23±18.07) and (364.19±12.25) pg/mL, respectively, and they were significantly higher than that in group D [(54.04±10.71) pg/mL] (P ＜ 0.05) . The serum level of TPO was positively correlated with CRP and IgA (rs=0.224, P=0.039; rs=0.239, P=0.033) , and was negatively correlated with C4 level (rs=?0.220, P=0.041) , but it was not significantly correlated with platelet count, erythrocyte sedimentation rate, the level of antiphospholipid antibodies and the titer of antinuclear antibodies (P ＞ 0.05) . The positive rate of PSS patients was 20.59% (21/102) and the rate in groups A, B, and C was respectively 17.5% (7/40) , 22.72% (5/22) , and 22.5% (9/40) . There was no statistically significant difference between the positive and negative groups in various clinical indexes (P ＞ 0.05) . ConclusionAntiTPO antibody may not be the main mechanism of thrombocytopenia in PSS patients, and there is a certain correlation between TPO and inflammatory factors.
Surgery is the preferred treatment for early esophageal cancer. Minimally invasive esophagectomy (MIE) can significantly reduce the incidence of postoperative complications and mortality, but due to the complex esophageal anatomy, intraoperative esophageal exposure, separation, anastomosis and lymph node dissection are difficult. The da Vinci surgical system provides a 3D vision and a more flexible as well as stable robotic arm, which is very helpful in completing fine surgical procedures. Robot-assisted minimally invasive esophagectomy(RAMIE) has been carried out in a number of countries, including China. Robot-assisted Ivor-Lewis esophagectomy (RAILE) is a transthoracic approach of robots developed in recent years. This paper summarizes the current researches on RAILE.
ObjectiveTo observe the efficacy and safety of colchicine combined with etofenamate cream in the treatment of acute gouty arthritis. MethodsA total of 150 patients diagnosed with acute gouty arthritis from June 2013 to July 2014 were equally randomized to receive colchicine alone (group A), colchicine with etofenamate cream (group B) and colchicine with etoricoxib (group C). The assessment on joint pain, tenderness, health quality and clinical efficacy of patients in each group was carried out, and the results were compared before and 7 days after the treatment. ResultsBecause of adverse events, the number of patients who withdrew from group A, B and C was respectively 2, 3 and 7. So the actual number of patients completing the study was 48 for group A, 47 for group B and 43 for group C. The patients' and physicians' assessments of mean change in pain intensity from baseline over days 1-7 were comparable in each group, with no statistical significance between groups (P>0.05). The patients' assessment of response to treatment was the highest in the colchicine with etofenamate cream group, and the differences compared with other two groups were significant (P=0.012 and 0.025, respectively). The physicians' global assessment of response to treatment showed no statistical significance between groups (F=0.021, P=0.908). The joint tenderness was most improved in colchicine with etoricoxib group, and the differences compared with other two groups were significant (P=0.041 and 0.034, respectively). The assessments of health quality were similar between groups. The C-reactive protein and erythrocyte sedimentation rate were decreased at study-end in all groups, but statistically significant differences were only found between group A and C (P<0.05). The incidence rate of adverse events was the highest in colchicine with etoricoxib group and the difference from other two groups was significant (P<0.05). ConclusionColchicine with etofenamate cream is as effective as colchicine with etoricoxib for treating acute gout and may have a better safety and tolerability profile.
目的 評價鹽酸氨基葡萄糖治療膝骨關節炎的療效。 方法 將2012年1月－5月收治的150例膝骨關節炎患者隨機分為A、B、C組。A組給予鹽酸氨基葡萄糖治療，B組給予碳酸鈣D3片治療，C組給予鹽酸氨基葡萄糖聯合碳酸鈣D3片治療，療程8周。3組患者膝關節疼痛發作時服用塞來昔布并記錄用量。比較試驗前后3組患者骨關節炎指數評分（WOMAC）以及第1、8周塞來昔布用量變化情況。 結果 3組患者WOMAC總分、疼痛程度評分、關節僵硬程度評分、日常活動困難程度評分改善值比較，差異均無統計學意義。經過8周治療，塞來昔布每周用量減少值A、B、C組分別為（0.41 ± 0.17）、（0.16 ± 0.22）、（0.46 ± 0.19）g，A、C組高于B組（P＜0.01），A、C組每周用量減少值差異無統計學意義（P＞0.05）。 結論 短期使用鹽酸氨基葡萄糖治療膝骨關節炎，在關節疼痛、僵硬及功能改善方面并不優于碳酸鈣D3片，但可通過減少非甾體抗炎藥物用量，使患者獲益。
ObjectiveTo compare the clinical efficacy of glucosamine hydrochloride and diacerein for patients with knee osteoarthritis and the MRI variation. MethodsBetween January and June 2014, 90 patients with knee osteoarthritis were randomized into three groups: group A (treated by glucosamine hydrochloride), group B (treated by diacerein) and group C (treated by both glucosamine hydrochloride and diacerein). The score of Western Ontario and McMaster Universities (WOMAC) index of osteoarthritis, MRI cartilage injury Recht grading and the curative effects for bone marrow edema, joint cavity effusion and meniscus injury were compared before and after the treatment. ResultsThe scores of WOMAC after treatment in all the groups were improved, while the therapeutic effect of group C lasted longer when medical treatment suspended. The number of articular surface with different degrees of cartilage injury showed no statistically significant change in all three groups (P ＞ 0.05) . The state of bone marrow edema and joint cavity effusion were improved with a statistically significant difference in all groups (P ＜ 0.05) . Patients with lateral meniscus degeneration in group A and patients with medial meniscal tear in group B both increased with statistically significant differences (P ＜ 0.05) . However, in group C, patients with lateral meniscus degeneration or meniscal tear decreased with statistically significant differences (P ＜ 0.05) . ConclusionsThe treatment for osteoarthritis by glucosamine hydrochloride is effective, and the curative effect lasts longer when treated by both glucosamine hydrochloride and diacerein. Glucosamine hydrochloride ameliorates the bone marrow edema and joint cavity effusion. Treatment together with diacerein leads to a better therapeutic effect for patients with meniscus degeneration, yet further studies are needed to prove its effects in ameliorating cartilage injury.
ObjectiveTo study the short-term efficacy and safety of tocilizumab in treating patients with active and resistant rheumatoid arthritis (RRA). MethodForty patients with RRA treated with tocilizumab between October 2013 and October 2014 were included in our study. The combined drug treatment was continued with the addition of tocilizumab 8 mg/kg per four weeks. The clinical responses and laboratory parameters were evaluated at the baseline, week 1, 4, 12, 16 and 24, and week 4 and 8 of tocilizumab withdrawal. ResultsTocilizumab was effective for several clinical lesions and laboratorial parameters at all time points. With the extension of treatment, the effect was better. At week 1, the visual analogue scale score of pain by patients, erythrocyte sedimentation rate, C-reactive protein (CRP), disease activity score 28 (DAS28) and health assessment questionnaire (HAQ) results decreased significantly (P<0.05). At week 12, the inflammatory biomarkers of all patients were normal, and 62.9% (22/35) of the patients achieved American College of Rheumatology (ACR)20, and 28.6% (10/35) of the patients achieved ACR50. At week 24, twelve patients achieved ACR50 and low activity (DAS28 score≤3.2), and the score of HAQ was minimum (3.1±1.6). The score of HAQ was significantly different between week 24 and the baseline (20.2±6.7) (P<0.01). All parameters were not significantly changed at week 4 of tocilizumab withdrawal compared with those before the withdrawal. Most parameters increased significantly at week 8 of tocilizumab withdrawal compared with week 4 of withdrawal (P<0.01) except for swollen joints, CRP, DAS28 and HAQ. The main adverse reactions were abnormal hepatic function and dyslipidemia followed by leukopenia. Only one patient stopped treatment because of adverse reaction. ConclusionsTocilizumab has rapid efficacy onset and good safety. After tocilizumab withdrawal, the efficacy can be maintained for 4 to 8 weeks.
ObjectiveTo observe the efficacy of self-behavior management combined with glucosamine hydrochloride for patients with early knee osteoarthritis. MethodsBetween October 2013 and March 2015, 240 patients with early knee osteoarthritis were randomly assigned to behavior therapy group (n=80) , drug treatment group (n=80) and combined treatment group (n=80) . Patients in the behavior therapy group were treated only by self-behavior management; patients in the drug treatment group were treated by glucosamine hydrochloride (0.48 g, three times per day); patients in the combined treatment group were treated by self-behavior management combined with glucosamine hydrochloride. The effect of treatment, adverse reactions, efficiency and expulsion rate were assessed 4, 8 and 12 weeks after treatment. ResultsThe Lequesne index and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) significantly decreased from week 4 when compared with week 0 after treatment in the combined treatment group, and there was a significant difference between the combined treatment group and single therapy group at week 8 and 12 (P ＜ 0.05) . The Lequesne index in the behavior therapy group and drug treatment group began to significantly decrease from week 8, and the WOMAC score significantly decreased from week 4 in the drug treatment group and from week 8 in the behavior therapy group. The efficiency increased with the treatment time prolonged in all three groups, but the efficiency in the combined treatment group was significantly higher than the single therapy group (P ＜ 0.05) . The shedding rates in the behavior therapy group, drug treatment group and combined treatment group were respectively 12.5%, 7.5% and 6.3%, without statistically significant difference (P ＞ 0.05) . The adverse reaction rate was low in all the three groups. ConclusionThe self-behavior management combined with glucosamine hydrochloride is an effective, safe and well-tolerated treatment for early knee osteoarthritis.