Objective To explore the effect of triple viable bifidobacterium lactobacillus tablets combined with polyethylene glycol 4000 on elderly patients with chronic constipation. Methods This pilot study was conducted at the Center of Gerontology and Geriatrics, West China Hospital. A total of 120 patients with chronic constipation, aged 60 years or older, treated between April 2015 and April 2016 were enrolled, and randomly assigned into group A (polyethylene glycol 4000) and group B (triple viable bifidobacterium lactobacillus tablets combined with polyethylene glycol 4000) with 60 patients in each. All the patients were estimated before and after the treatment with Bristol Stool Form Scale (BSFS), Patient Assessment of Constipation Symptom (PAC-SYM) and Constipation Related Disability (CRDS), and the adverse drug reactions were observed. Results In group A, before the treatment, the scores of BSFS, PAC-SYM and CRDS were 1.98±0.77, 37.87±4.12 and 31.03±3.19, respectively; while after the treatment, the scores were 3.87±0.82, 28.55±2.15 and 18.56±1.80, respectively, which were all significantly improved (P<0.05). In group B, before the treatment, the scores of BSFS, PAC-SYM and CRDS were 2.03±0.78, 36.25±4.98 and 30.28±3.56, respectively; while after the treatment, the scores were 4.80±0.75, 19.73±3.42 and 13.80±2.36, respectively, which were all significantly improved (P<0.05). The improvement of constipation in group B was significantly better than that in group A after treatment (P<0.05). There was no adverse drug reaction observed. Conclusion Triple viable bifidobacterium lactobacillus tablets combined with polyethylene glycol 4000 may be an effective therapy for elderly patients with chronic constipation.
【摘要】 目的 評價生長抑素聯合中藥在治療重癥急性胰腺炎中的有效性。 方法 應用國際Cochrane協作網系統評價方法對生長抑素聯合中藥治療重癥急性胰腺炎的隨機對照試驗（RCT）進行系統評價。計算機檢索MEDLINE（Ovid）、PubMed數據庫、中文科技期全文數據庫（VIP）、萬方數據庫、中國期刊全文數據庫（CNKI）、中國生物醫學文獻數據庫（CBM）。檢索時間均為建庫至2009年9月。文獻檢索語種為英語和中文。 結果 共納入8個RCT，436例患者，所有納入試驗在治療末均未進行隨訪。Meta分析結果顯示，生長抑素聯合中藥治療組（治療組）的病死率（13/188，6.9%）明顯低于單純生長抑素治療組（對照組）（24/174，13.7%），差異有統計學意義[Peto OR=0.46，95%CI（0.22，0.94），Plt;0.05]。治療組平均住院日低于對照組[WMD=-7.01，95%CI（-7.89，-6.13），Plt;0.000 01]。治療組腹痛緩解時間明顯低于對照組，其差異有統計學意義[WMD=-0.77，95%CI（-0.82，-0.72），Plt;0.000 01]。治療組與對照組治療第7天APACHE Ⅱ評分均下降，治療組下降幅度大于對照組，兩組比較差異有統計學意義（Plt;0.05）。治療組并發癥發生率（26/91，28.6%）與對照組（35/88，39.8%）相比，其差異無統計學意義[Peto OR=0.61，95%CI（0.32，1.13），P=0.12]。 結論 生長抑素聯合中藥治療在改善重癥急性胰腺炎的病死率、平均住院時間、腹痛緩解時間、APACHE Ⅱ評分下降幅度優于單純生長抑素治療。
ObjectiveTo investigate the relationship between the expression of programmed cell death ligand-1 (PD-L1) and the maximal standardized uptake value (SUVmax) in 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and the correlation of clinical factors between SUVmax values and PD-L1.MethodsThe clinical data of 84 patients with invasive lung adenocarcinoma diagnosed pathologically in West China Hospital, Sichuan University from August 2016 to November 2018 were analyzed retrospectively, including 38 males and 46 females, aged 60 (32-85) years. The tumor was acinar-predominant in 37 patients, papillary in 20, lepidic in 19, solid in 5 and micropapillary in 3. Multivariate analysis of the relationship between SUVmax value and other clinicopathological features was performed by linear regression. Logistic regression analysis was used to analyze the relationship between PD-L1 protein expression and other pathological features.ResultsThe SUVmax of the PD-L1 expression group was significantly higher than that of the non-PD-L1 expression group in the whole invasive lung adenocarcinoma group (P=0.002) and intermediate-grade histologic subtype (P=0.016). The SUVmax cut-off value of PD-L1 expression in the whole invasive lung adenocarcinoma group and intermediate-grade histologic subtype was 5.34 (AUC: 0.732, P=0.002) and 5.34 (AUC: 0.720, P=0.017), respectively. Multivariate analysis showed that pleura involvement, vascular tumor thrombus and the increase of tumor diameter could cause the increase of the SUVmax value, while the SUVmax value decreased in the moderately differentiated tumor compared with the poorly differentiated tumor. The SUVmax cut-off value between low-grade histologic subtype and intermediate-grade histologic subtype, intermediate-grade histologic subtype and high-grade histologic subtypes was 1.54 (AUC: 0.854, P<0.001) and 5.79 (AUC: 0.889, P<0.001), respectively. Multivariate analysis of PD-L1 expression showed pleura involvement (P=0.021, OR=0.022, 95%CI 0.001 to 0.558) and moderate differentiation (opposite to poor differentiation) (P=0.004, OR=0.053, 95%CI 0.007 to 0.042) decreased the expression of PD-L1.ConclusionThe SUVmax of the PD-L1 expression group is significantly higher than that of the non-PD-L1 expression group in the whole invasive lung adenocarcinoma group and intermediate-grade histologic subtype. The level of SUVmax and the expression of PD-L1 in invasive lung adenocarcinoma are related to many clinical factors.