In this article,the mechanism of inheritance behind inherited hearing loss and genetic susceptibilityin noise-induced hearing loss are reviewed.Conventional treatments for sensorineural hearing loss(SNHL),i.e.hearing ...In this article,the mechanism of inheritance behind inherited hearing loss and genetic susceptibilityin noise-induced hearing loss are reviewed.Conventional treatments for sensorineural hearing loss(SNHL),i.e.hearing aid and cochlear implant,are effective for some cases,but not without limitations.For example,they provide little benefit for patients of profound SNHL or neural hearing loss,especially when the hearing loss is in poor dynamic range and with low frequency resolution.We emphasize the most recent evidence-based treatment in this field,which includes gene therapy and allotransplantation of stem cells.Their promising results have shown that they might be options of treatment for profound SNHL and neural hearing loss.Although some treatments are still at the experimental stage,it is helpful to be aware of the novel therapies and endeavour to explore the feasibility of their clinical application.展开更多
BACKGROUND Postoperative discal pseudocyst(PDP)is a rare condition that presents after surgery for lumbar disc herniation.Due to the lack of information,the diagnosis and treatment of PDP remain controversial.Herein,w...BACKGROUND Postoperative discal pseudocyst(PDP)is a rare condition that presents after surgery for lumbar disc herniation.Due to the lack of information,the diagnosis and treatment of PDP remain controversial.Herein,we report a PDP case that occurred following percutaneous endoscopic lumbar discectomy and received conservative treatment.Additionally,we review all the published literature regarding PDP and propose our hypothesis regarding PDP pathology.CASE SUMMARY A 23-year-old man presented with a relapse of low back pain and numbness in his left lower extremity after undergoing percutaneous endoscopic lumbar discectomy for lumbar disc herniation.Repeat magnetic resonance imaging demonstrated a cystic lesion at the surgical site with communication with the inner disc.The patient was diagnosed as having PDP.The patient received conservative treatment,which resulted in rapid improvement and spontaneous regression of the lesion,and had a favorable outcome in follow-up.CONCLUSION PDP and discal cyst(DC)exhibit similarities in both histological and epidemiological characteristics,which indicates the same pathological origin of PDP and DC.The iatrogenic annular injury during discectomy might accelerate the pathological progression of DC.For patients with mild to moderate symptoms,conservative treatment can lead to great improvement,even inducing spontaneous regression.However,surgical cystectomy is necessary in patients with neurological deficits and where conservative treatment is ineffective.展开更多
Background:The Shexiang Baoxin Pill(MUSKARDIA)has been used for treating coronary artery disease(CAD)and angina for more than 30 years in China.Nevertheless,methodologically sound trials on the use of MUSKARDIA in CAD...Background:The Shexiang Baoxin Pill(MUSKARDIA)has been used for treating coronary artery disease(CAD)and angina for more than 30 years in China.Nevertheless,methodologically sound trials on the use of MUSKARDIA in CAD patients are scarce.The aim of the study is to determine the effects of MUSKARDIA as an add-on to optimal medical therapy(OMT)in patients with stable CAD.Methods:A total of 2674 participants with stable CAD from 97 hospitals in China were randomized 1:1 to a MUSKARDIA or placebo group for 24 months.Both groups received OMT according to local tertiary hospital protocols.The primary outcome was the occurrence of a major adverse cardiovascular event(MACE),defined as a composite of cardiovascular death,non-fatal myocardial infarction(MI),or non-fatal stroke.Secondary outcomes included all-cause mortality,non-fatal MI,non-fatal stroke,hospitalization for unstable angina or heart failure,peripheral revascularization,angina stability and angina frequency.Results:In all,99.7%of the patients were treated with aspirin and 93.0%with statin.After 2 years of treatment,the occurrence of MACEs was reduced by 26.9%in the MUSKARDIA group(MUSKARDIA:1.9%vs.placebo:2.6%;odds ratio=0.80;95%confidence interval:0.45-1.07;P=0.2869).Angina frequency was significantly reduced in the MUSKARDIA group at 18 months(P=0.0362).Other secondary endpoints were similar between the two groups.The rates of adverse events were also similar between the two groups(MUSKARDIA:17.7%vs.placebo:17.4%,P=0.8785).Conclusions:As an add-on to OMT,MUSKARDIA is safe and significantly reduces angina frequency in patients with stable CAD.Moreover,the use of MUSKARDIA is associated with a trend toward reduced MACEs in patients with stable CAD.The results suggest that MUSKARDIA can be used to manage patients with CAD.Trial registration:chictr.org.cn,No.ChiCTR-TRC-12003513.展开更多
文摘In this article,the mechanism of inheritance behind inherited hearing loss and genetic susceptibilityin noise-induced hearing loss are reviewed.Conventional treatments for sensorineural hearing loss(SNHL),i.e.hearing aid and cochlear implant,are effective for some cases,but not without limitations.For example,they provide little benefit for patients of profound SNHL or neural hearing loss,especially when the hearing loss is in poor dynamic range and with low frequency resolution.We emphasize the most recent evidence-based treatment in this field,which includes gene therapy and allotransplantation of stem cells.Their promising results have shown that they might be options of treatment for profound SNHL and neural hearing loss.Although some treatments are still at the experimental stage,it is helpful to be aware of the novel therapies and endeavour to explore the feasibility of their clinical application.
文摘BACKGROUND Postoperative discal pseudocyst(PDP)is a rare condition that presents after surgery for lumbar disc herniation.Due to the lack of information,the diagnosis and treatment of PDP remain controversial.Herein,we report a PDP case that occurred following percutaneous endoscopic lumbar discectomy and received conservative treatment.Additionally,we review all the published literature regarding PDP and propose our hypothesis regarding PDP pathology.CASE SUMMARY A 23-year-old man presented with a relapse of low back pain and numbness in his left lower extremity after undergoing percutaneous endoscopic lumbar discectomy for lumbar disc herniation.Repeat magnetic resonance imaging demonstrated a cystic lesion at the surgical site with communication with the inner disc.The patient was diagnosed as having PDP.The patient received conservative treatment,which resulted in rapid improvement and spontaneous regression of the lesion,and had a favorable outcome in follow-up.CONCLUSION PDP and discal cyst(DC)exhibit similarities in both histological and epidemiological characteristics,which indicates the same pathological origin of PDP and DC.The iatrogenic annular injury during discectomy might accelerate the pathological progression of DC.For patients with mild to moderate symptoms,conservative treatment can lead to great improvement,even inducing spontaneous regression.However,surgical cystectomy is necessary in patients with neurological deficits and where conservative treatment is ineffective.
基金This study was funded by the Shanghai Science and Technology Committee and Shanghai Hutchison Pharmaceuticals Company.
文摘Background:The Shexiang Baoxin Pill(MUSKARDIA)has been used for treating coronary artery disease(CAD)and angina for more than 30 years in China.Nevertheless,methodologically sound trials on the use of MUSKARDIA in CAD patients are scarce.The aim of the study is to determine the effects of MUSKARDIA as an add-on to optimal medical therapy(OMT)in patients with stable CAD.Methods:A total of 2674 participants with stable CAD from 97 hospitals in China were randomized 1:1 to a MUSKARDIA or placebo group for 24 months.Both groups received OMT according to local tertiary hospital protocols.The primary outcome was the occurrence of a major adverse cardiovascular event(MACE),defined as a composite of cardiovascular death,non-fatal myocardial infarction(MI),or non-fatal stroke.Secondary outcomes included all-cause mortality,non-fatal MI,non-fatal stroke,hospitalization for unstable angina or heart failure,peripheral revascularization,angina stability and angina frequency.Results:In all,99.7%of the patients were treated with aspirin and 93.0%with statin.After 2 years of treatment,the occurrence of MACEs was reduced by 26.9%in the MUSKARDIA group(MUSKARDIA:1.9%vs.placebo:2.6%;odds ratio=0.80;95%confidence interval:0.45-1.07;P=0.2869).Angina frequency was significantly reduced in the MUSKARDIA group at 18 months(P=0.0362).Other secondary endpoints were similar between the two groups.The rates of adverse events were also similar between the two groups(MUSKARDIA:17.7%vs.placebo:17.4%,P=0.8785).Conclusions:As an add-on to OMT,MUSKARDIA is safe and significantly reduces angina frequency in patients with stable CAD.Moreover,the use of MUSKARDIA is associated with a trend toward reduced MACEs in patients with stable CAD.The results suggest that MUSKARDIA can be used to manage patients with CAD.Trial registration:chictr.org.cn,No.ChiCTR-TRC-12003513.
