Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the...Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the pathological part of healing following any peritoneal injury, particularly due to abdominal surgery. The balance between fi brin deposition and degradation is critical in determining normal peritoneal healing or adhesion formation. Postoperative peritoneal adhesions are a major cause of morbidity resulting in multiple complications, many of which may manifest several years after the initial surgical procedure. In addition to acute small bowel obstruction, peritoneal adhesions may cause pelvic or abdominal pain, and infertility. In this paper, the authors reviewed the epidemiology, pathogenesis and various prevention strategies of adhesion formation, using Medline and PubMed search. Several preventive agents against postoperative peri-toneal adhesions have been investigated. Their role aims in activating fi brinolysis, hampering coagulation, diminishing the inflammatory response, inhibiting col-lagen synthesis or creating a barrier between adjacentwound surfaces. Their results are encouraging but most of them are contradictory and achieved mostly in animal model. Until additional fi ndings from future clinical researches, only a meticulous surgery can be recommended to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery. In the current state of knowledge, pre-clinical or clini-cal studies are still necessary to evaluate the effective-ness of the several proposed prevention strategies of postoperative peritoneal adhesions.展开更多
Purpose： Posttraumatic arthritis （PTA） may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have as...Purpose： Posttraumatic arthritis （PTA） may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty （THA） in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture. Methods： Pubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords ＂acetabular＂, ＂fracture＂, ＂arthroplasty＂, and ＂post traumatic arthritis＂ published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies. Results： With 1830 studies were screened and data from 10 studies with 448 patients were included in this review, The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27-74 months. Mean follow-up times ranged from 4 to 20 years, The mean Harris hip scores （HHS） improved from 41.5 pre-operatively, to 87.6 post-operatively, The most prevalent postoperative complications were heterotopic ossification （28% -63%）, implant loosening （1%-24%）, and infection （0%-16%）. The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%. Conclusion： Despite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture （including soft tissue scarring, existing hardware, and acetabular bone loss） and the relatively high complication rates, THA in patients with VIA following prior acetabular fracture leads to significant improvement in展开更多
Herbal products are increasingly used, mainly in chronic liver disease. Extracts of milk thistle, Silymarin and silybin, are the most prescribed natural compounds, with different indications, but with no definitive re...Herbal products are increasingly used, mainly in chronic liver disease. Extracts of milk thistle, Silymarin and silybin, are the most prescribed natural compounds, with different indications, but with no definitive results in terms of clinical efficacy. This review analyzes the available studies on the effects of the purified product silybin, both as a free and a conjugated molecule, on liver cells or on experimentally induced liver damage, and in patients with liver disease. We searched PUBMED for articles pertaining to the in vitro and in vivo effects of silybin, its antifibrotic, anti-inflammatory, and antioxidant properties, as well as its metabolic effects, combined with the authors’ own knowledge of the literature. Results indicate that the bioavailability of silybin phytosome is higher than that of silymarin and is less influenced by liver damage; silybin does not show significant interactions with other drugs and at doses < 10 g/d has no significant side effects. Experimental studies have clearly demonstrated the antifibrotic, antioxidant and metabolic effects of silybin; previous human studies were insufficient for confirming the clinical efficacy in chronic liver disease, while ongoing clinical trials are promising. On the basis of literature data, silybin seems a promising drug for chronic liver disease.展开更多
The aims of this paper were to define(1) criteria of cerebral palsy;(2) classification of cerebral palsy;(3) etiology,neuroimaging,and epidemiology of cerebral palsy;(4) different kinds of treatments of cerebral palsy...The aims of this paper were to define(1) criteria of cerebral palsy;(2) classification of cerebral palsy;(3) etiology,neuroimaging,and epidemiology of cerebral palsy;(4) different kinds of treatments of cerebral palsy.Data were drawn from an international survey of PUBMED(1994~2014) and CNKI(1994~2014).An expert panel used a consensus building technique.The10-point Jadad scale was used to assess the quality of the trials based on the following items,including allocation sequence generation,randomization concealment,methods of blinding,and descriptions of withdrawals and dropouts.Our clinical experience was also summarized.Below is a summary.(1) Further work is warranted to reach agreement for the classification of cerebral palsy.(2) A worldwide prevalence of 1.5~4.0 per 1 000 live births,with an average lifetime cost of 1 million dollars per person in the United States,while it is 1.8~6.0per 1 000 live births in China.(3) Comparison of clinical efficacy of different treatments.In this review,the current advances in different kind of treatments of brain injury are discussed with specific relevance to cerebral palsy.展开更多
文摘Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the pathological part of healing following any peritoneal injury, particularly due to abdominal surgery. The balance between fi brin deposition and degradation is critical in determining normal peritoneal healing or adhesion formation. Postoperative peritoneal adhesions are a major cause of morbidity resulting in multiple complications, many of which may manifest several years after the initial surgical procedure. In addition to acute small bowel obstruction, peritoneal adhesions may cause pelvic or abdominal pain, and infertility. In this paper, the authors reviewed the epidemiology, pathogenesis and various prevention strategies of adhesion formation, using Medline and PubMed search. Several preventive agents against postoperative peri-toneal adhesions have been investigated. Their role aims in activating fi brinolysis, hampering coagulation, diminishing the inflammatory response, inhibiting col-lagen synthesis or creating a barrier between adjacentwound surfaces. Their results are encouraging but most of them are contradictory and achieved mostly in animal model. Until additional fi ndings from future clinical researches, only a meticulous surgery can be recommended to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery. In the current state of knowledge, pre-clinical or clini-cal studies are still necessary to evaluate the effective-ness of the several proposed prevention strategies of postoperative peritoneal adhesions.
文摘Purpose： Posttraumatic arthritis （PTA） may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty （THA） in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture. Methods： Pubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords ＂acetabular＂, ＂fracture＂, ＂arthroplasty＂, and ＂post traumatic arthritis＂ published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies. Results： With 1830 studies were screened and data from 10 studies with 448 patients were included in this review, The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27-74 months. Mean follow-up times ranged from 4 to 20 years, The mean Harris hip scores （HHS） improved from 41.5 pre-operatively, to 87.6 post-operatively, The most prevalent postoperative complications were heterotopic ossification （28% -63%）, implant loosening （1%-24%）, and infection （0%-16%）. The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%. Conclusion： Despite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture （including soft tissue scarring, existing hardware, and acetabular bone loss） and the relatively high complication rates, THA in patients with VIA following prior acetabular fracture leads to significant improvement in
文摘Herbal products are increasingly used, mainly in chronic liver disease. Extracts of milk thistle, Silymarin and silybin, are the most prescribed natural compounds, with different indications, but with no definitive results in terms of clinical efficacy. This review analyzes the available studies on the effects of the purified product silybin, both as a free and a conjugated molecule, on liver cells or on experimentally induced liver damage, and in patients with liver disease. We searched PUBMED for articles pertaining to the in vitro and in vivo effects of silybin, its antifibrotic, anti-inflammatory, and antioxidant properties, as well as its metabolic effects, combined with the authors’ own knowledge of the literature. Results indicate that the bioavailability of silybin phytosome is higher than that of silymarin and is less influenced by liver damage; silybin does not show significant interactions with other drugs and at doses < 10 g/d has no significant side effects. Experimental studies have clearly demonstrated the antifibrotic, antioxidant and metabolic effects of silybin; previous human studies were insufficient for confirming the clinical efficacy in chronic liver disease, while ongoing clinical trials are promising. On the basis of literature data, silybin seems a promising drug for chronic liver disease.
基金supported by Special Financial Grant from the China Postdoctoral Science Foundation (2012750866)
文摘The aims of this paper were to define(1) criteria of cerebral palsy;(2) classification of cerebral palsy;(3) etiology,neuroimaging,and epidemiology of cerebral palsy;(4) different kinds of treatments of cerebral palsy.Data were drawn from an international survey of PUBMED(1994~2014) and CNKI(1994~2014).An expert panel used a consensus building technique.The10-point Jadad scale was used to assess the quality of the trials based on the following items,including allocation sequence generation,randomization concealment,methods of blinding,and descriptions of withdrawals and dropouts.Our clinical experience was also summarized.Below is a summary.(1) Further work is warranted to reach agreement for the classification of cerebral palsy.(2) A worldwide prevalence of 1.5~4.0 per 1 000 live births,with an average lifetime cost of 1 million dollars per person in the United States,while it is 1.8~6.0per 1 000 live births in China.(3) Comparison of clinical efficacy of different treatments.In this review,the current advances in different kind of treatments of brain injury are discussed with specific relevance to cerebral palsy.
