Adefovir Dipivoxil plus Chinese Medicine in HBeAg-Positive Chronic Hepatitis B Patients: A Randomized Controlled 48-Week Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the effects of a 48-week course of adefovir dipivoxil (ADV) plus Chinese medicine (CM) therapy, namely Tiaogan Jianpi Hexue () and Tiaogan Jiedu Huashi () fomulae, in hepatitis B e antigen (HBeAg)-positive Chinese patients.@*METHODS@#A total of 605 HBeAg-positive Chinese CHB patients were screened and 590 eligible participants were randomly assigned to 2 groups in 1:1 ratio including experimental group (EG, received ADV plus CM) and control group (CG, received ADV plus CM-placebo) for 48 weeks. The major study outcomes were the rates of HBeAg and HBV-DNA loss on week 12, 24, 36, 48, respectively. Secondary endpoints including liver functions (enzymes and bilirubin readings) were evaluated every 4 weeks at the beginning of week 24, 36, and 48. Routine blood, urine, and stool analyses in addition to electrocardiogram and abdominal B scan were monitored as safety evaluations. Adverse events (AEs) were documented.@*RESULTS@#The combination therapy demonstrated superior HBeAg loss at 48 weeks, without additional AEs. The full analysis population was 560 and 280 in each group. In the EG, population achieved HBeAg loss on week 12, 24, 36, and 48 were 25 (8.90%), 34 (12.14%), 52 (18.57%), and 83 (29.64%), respectively; the equivalent numbers in the CG were 20 (7.14%), 41 (14.64%), 54 (19.29%), and 50 (17.86%), respectively. There was a statistically significant difference between these group values on week 48 (P<0.01). No additional AEs were found in EG. Subgroup analysis suggested different outcomes among treatment patterns.@*CONCLUSION@#Combination of CM and ADV therapy demonstrated superior HBeAg clearance compared with ADV monotherapy. The finding indicates that this combination therapy may provide an improved therapeutic effect and safety profile (ChiCTR-TRC-11001263).

Application of double-low technique and iterative reconstruction in 64-slice MSCT pulmonary angiography / 医疗卫生装备

The development of CT and the clinical application of CT pulmonary angiography (CTPA) in diagnosing pulmonary embolism were introduced,and the methods for decreasing CTPA radiation dose and the importance of iterative reconstruction for low-dose scanning were analyzed.The development and application of contrast agent were described,and the ways to reduce contrast agent dose was expounded.Double-low CTPA combined with iterative reconstruction was pointed out to decrease greatly the radiation dose and contrast agent iodine dose while ensured image quality,and thus the damages to the patient by radiation and contrast agent could be lowered at the most.

Efficacy and safety of Tripterygium wilfordii hook F versus acitretin in moderate to severe psoriasis vulgaris: a randomized clinical trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Few clinical trials have evaluated the efficacy and safety of Tripterygium wilfordii Hook F (TwHF) compared with acitretin in psoriasis. We aimed to compare the efficacy and safety of TwHF compared with acitretin in the treatment of moderate to severe psoriasis vulgaris.</p><p><b>METHODS</b>Adults with Psoriasis Area Severity Index (PASI) score ≥ 10 and psoriasis-affected body surface area ≥ 10% were randomized into a TwHF (20 mg, 3 times a day) or acitretin group (30 mg, once a day). The treatment course lasted for 8 weeks. Patients were assessed at baseline and at 2, 4, and 8 weeks. Laboratory tests were performed at baseline, week 4, and week 8. The data were analyzed using paired samples t-test or analysis of variance (ANOVA).</p><p><b>RESULTS</b>A total of 115 patients was enrolled (58 TwHF; 57 acitretin). The median PASI score improved in the TwHF group by 50.4% and in the acitretin group by 42.7%. There was no significant difference in median PASI improvement between two groups at 2, 4, and 8 weeks. There was also no significant difference in PASI 25, PASI 50, PASI 75, and PASI 90 response between the two groups at 2, 4, and 8 weeks. There was a significant increase in the level of aspartate transaminase and triglycerides in the TwHF group (P = 0.026 and P = 0.011, respectively). In the acitretin group, there was a significant increase in the level of alanine transaminase, cholesterol, and high-density lipoprotein (P = 0.030, P < 0.01, and P < 0.01, respectively).</p><p><b>CONCLUSIONS</b>There was no significant difference in treatment efficacy between the TwHF and acitretin groups within 8 weeks, but there were fewer treatment-related adverse events in the TwHF group.</p>

Clinical differential diagnosis of type III prostatitis and interstitial cystitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the differential diagnosis of type III prostatitis and interstitial cystitis so as to improve the efficiency of diagnosis and treatment of the two diseases.</p><p><b>METHODS</b>Based on the clinical data of 4 cases of type III prostatitis and 3 cases of interstitial cystitis, we analyzed the characteristics of the two diseases in such aspects as clinical symptomatology, urodynamics, prostatic fluid microscopy, microbiology and treatment.</p><p><b>RESULTS</b>The common clinical characteristics of type III prostatitis and interstitial cystitis were indisposition or pain in the subabdomen and/or pelvic floor, but their differences were quite obvious. In interstitial cystitis, longer urine accumulation could cause worse pain in the subabdomen, which could be relieved after micturation, and the bladder capacity was obviously decreased, but with normal prostatic fluid and negative result of microbial culture. It responded to behavior therapy, resiniferatoxin, sodium hyaluronate and water dilation of the bladder under anaesthesia. While type III prostatitis, with white blood cells > 10/HP or < or = 10/HP in the prostatic fluid and negative result of microbial culture, did not respond to the above therapeutic methods that were effective for interstitial cystitis.</p><p><b>CONCLUSION</b>Type III prostatitis and interstitial cystitis, although clinically confusable, can be definitely differentiated from each other according to their characteristic causes and locations.</p>