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ObjectiveTo systematically review the studies about Yiqing Capsules in the treatment of pharyngitis， tonsillitis， gingivitis， and oral ulcers with heat-toxin syndrome and clarify the advantages and therapeutic characteristics of Yiqing capsules， thus providing reference for the decision-making by relevant departments and clues for the clinical and basic research. MethodThe multi-criteria decision analysis （MCDA） model and CSC v2.0 were employed to comprehensively evaluate Yiqing capsules from multiple aspects. ResultThe serious adverse reactions in the spontaneous reporting system （SRS） monitoring data of Yiqing capsules included pruritus， rash， an ddiarrhea， all of which were relieved or cured， without aggravation or interhospital transfer for treatment. Literature data showed that the main clinical adverse reactions were abdominal pain， diarrhea， etc. Both acute toxicity and long-term toxicity tests showed good safety， and thus the safety of Yiqing capsules was rated as grade B. The results of Meta-analysis showed that Yiqing capsules used alone or in combination with other medicines outperformed Niuhuang Jiedu capsules or Western medicine in the treatment of pharyngitis， tonsillitis， gingivitis， and oral ulcers with heat toxin in terms of symptom alleviation， disappearance rate of main symptoms， and recurrence rate of aphtha. Pharmacological and pharmacodynamic studies showed that Yiqing capsules had antimicrobial， antiviral， and anti-inflammatory effects， with the effectiveness rated as grade B. The decision tree model was adopted to analyze the incremental cost-effectiveness ratio. With the threshold of 1 fold per capita GDP and the disappearing rate of pain in gingivitis as the indicator， Yiqing capsules had an economic advantage in the treatment of gingivitis due to heat-toxin compared with Niuhuang Jiedu capsules， and the incremental cost-effectiveness ratio was 0.39 yuan/%， which indicated acceptable cost， with the economy rated as grade B. Yiqing capsules can not only clear heat from Qi aspect but also purge blood fire， serving as the representative prescription of clearing and purging for heat-toxin syndrome. Considering the industrial service system and enterprise innovation， the comprehensive innovation of Yiqing capsules was rated as grade B. Generally， this product does not require personalized treatment plans and features convenient supply， storage， transportation， policy publicity， drug information standards， and easy operation for medical care and patients. The Chinese patent medicine information was complete and in line with national standards， and thus the suitability of Yiqing capsules was rated as grade A. With a low price and good availability and affordability， the accessibility of Yiqing capsules was rated as grade A. The Yiqing capsules prescription， Sanhuang Xiexin decoction， originated from ancient medical books， with rich real-world studies， and thus the traditional Chinese medicine characteristics of Yiqing capsules was rated as grade C. ConclusionThe clinical value of Yiqing capsules was rated as grade B from the "6+1" dimensions， suggesting that it could be conditionally converted into the relevant policy results of basic clinical drug management according to the procedure.
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ObjectiveTo explore the comprehensive clinical value of Qianlieping capsules in the treatment of chronic prostatitis with damp-heat stasis syndrome， and to provide evidence for the decision-making of clinical basic drug management. MethodBased on the "Guidelines for Comprehensive Clinical Evaluation of Drugs （Trial Version 2021）"， this study systematically reviewed the existing research on the treatment of chronic prostatitis with damp-heat stasis syndrome by Qianlieping capsules. Based on evidence-based medicine， clinical epidemiology， clinical medicine， evidence-based pharmacy， pharmacoeconomics， health statistics， health technology assessment， and other disciplines， the multi-criteria decision analysis model （MCDA） and CSC 2.0 software were used. The six dimensions of safety， effectiveness， economy， innovation， suitability， and accessibility of drugs， as well as traditional Chinese medicine（TCM） characteristics， were comprehensively evaluated qualitatively and quantitatively. ResultIn terms of safety， based on the spontaneous reporting system （SRS） of the National Center for ADR Monitoring， safety literature analysis， pharmacological and toxicological experiment report， and other evidence， the safety grade of Qianlieping capsules was evaluated as grade A， with good safety. In terms of effectiveness， based on the results of pharmacological and pharmacodynamic studies and Meta-analysis， and combined with the value and quality of the evidence for efficacy， the final efficacy grade of Qianlieping capsules was rated as B. In terms of economy， Qianlieping capsules was a class B drug of national medical insurance. Compared with those of similar Chinese patent medicines， the average daily cost of Qianlieping capsules was moderate， and there was no related cost increase during the administration process. Economic research showed that Qianlieping capsules combined with α-receptor blockers were more economical than α-receptor blockers alone. Based on the quality evaluation of economic evidence and the value evaluation of economic evidence， the economic grade of Qianlieping capsules was rated as B. In terms of innovation， Qianlieping capsules were a combination of cold and warm drugs， focusing on clearing heat， detoxifying， removing blood stasis， and relieving pain， with non-toxic medicinal materials. They obtained a number of invention patents. The enterprise service system was perfect， and the quality standard was higher than the international and Chinese standards. The innovation grade of Qianlieping capsules was rated as B. In terms of suitability， the results of the questionnaire survey showed that it had relatively good suitability for clinicians， nurses， pharmacists， and patients who used Qianlieping capsules. The information on Chinese patent medicines was complete and met the requirements of national standards. The suitability grade of Qianlieping capsules was rated as A. In terms of accessibility， Qianlieping capsules were moderately priced and affordable， with sufficient resources of medicinal materials， no shortage of medicinal materials， and good availability. The accessibility grade of Qianlieping capsules was rated as B. In terms of TCM medicine characteristics， the prescription of Qianlieping capsules was derived from Danshen Huoxue Decoction. The original prescription was used for the treatment of chronic prostatitis with blood stasis syndrome. The whole formula was recorded in The Complete Compendium of Fine Formulas （《良方大全》） published by Beijing Publishing Group Co.， Ltd. in 1991 and has been used for more than 30 years. The formula was a combination of warm and cold drugs， attacking pathogens without hurting healthy Qi. The grade of TCM characteristics of Qianlieping capsules was rated as B. ConclusionBased on the above "6+1" dimensions， the comprehensive evaluation result of Qianlieping capsules in the treatment of chronic prostatitis with damp-heat and blood stasis syndrome is grade B， and it is recommended to convert it into the relevant policy results of basic clinical drug management according to the conditions.
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Objective Diagnosis of contrast-enhanced ultrasound ( CEUS) for small focal liver lesions under the background of hepatocirrhosis has been a difficult problem in clinical practice .CEUS has significantly improved the accuracy of liver cancer diagno-sis, but little research has been done in minimal lesions .The article was to investigate the diagnostic value of CEUS in liver cirrhosis with small focal liver lesions (≤2 cm) . Methods 70 patients with cirrhosis and 76 small focal hepatic lesions who were admitted in our hospital from March 2015 to August 2015 were examined by conventional ultrasound and CEUS .Comparative analysis was made be-tween the results of tests and pathology to calculate the sensitivity , specificity and accuracy of CEUS and conventional ultrasound . Results The sensitivity , specificity and accuracy in diagnosing small hepatic cancer lesions complicated with cirrhosis by CEUS and conventional ultrasound were 47.6%、79.4%、61.8%and97.6%、97.1%、97.4%,respectively.CEUS was in high consistence with the results of pathology ( Kappa 0.947) and significantly higher than those of conventional ultrasound (Kappa 0.259). Conclusion CEUS has high application value in the differential diagnosis of small focal he-patic lesions complicated with cirrhosis .
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Objective To discuss the predictable factors for the occurrence of intraoperative aneurysm rupture(IAR) of anterior circulation aneurysm treated by clipping.Methods The clinical data of 96 patients with 115 aneurysms treated by clipping were retrospectively analyzed.The univariate analysis and Logistic regression analysis was performed for the risk factors of IAR such as history of hypertension,pre-operative Hunt-Hess scale,aneurysm location,aneurysm sac,aneurysm dome/neck ratio,aneurysm direction,and operation time.Results Twenty-one patients occurred IAR [18.3 ％ (21/115) of aneurysms,21.9％ (21/96) of patients] during the operation,2 patients died and 94 patients were estimated by Rank scale:0 score was for 66 patients,2 scores was for 10 patients,3 scores was for 6 patients,4 scores was for 4 patients,5 scores was for 6 patients and 6 scores was for 2 patients at 6 months after surgery.Statistic analysis revealed that history of hypertension (P =0.037),pre-operative Hunt-Hess scale (P =0.040),aneurysm direction (P =0.009),aneurysm sac (P =0.010),operation time (P =0.001) and aneurysm dome/neck ratio (P =0.029) were the predictable factors for the occurrence of IAR,while aneurysm location was not included (P =0.198).Conclusion The history of hypertension,pre-operative Hunt-Hess scale,aneurysm direction,aneurysm sac,operation time and aneurysm dome/neck ratio 1.78-2.89 are the predictable factors for the occurrence of IAR and the combination of various factors lead to the occurrence of IAR.
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OBJECTIVE@#To analyze the clinical features and treatment protocols of primary laryngeal amyloidosis.@*METHOD@#Retrospective study of 5 patient hospitalized from 1996 - 2011. All of the patients by resection lesions, including four routine throat tumor resection, and burst throat by supporting laryngoscope in 1 case, all did not give lesions resection radiation and hormone therapy.@*RESULT@#All the 5 patients recovered clinically. There were 3 patients followed up for 0.3-7.5 years with a mean time of 3.3 years without recurrence, 2 patients lost follow-up.@*CONCLUSION@#Middle ages seemed to be more vulnerable. The most common disease region is true vocal cord, followed by false vocal cord, epiglottis former clearance etc. Early surgical treatment of this disease is the most important treatment, larynx endoscopic and CT for the diagnosis of great value, and pathologic biopsy especially Congo red stain positive is the basis of the specific diagnosis of this disease.
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Humans , Age Factors , Amyloidosis , Pathology , General Surgery , Biopsy , Immunoglobulin Light-chain Amyloidosis , Laryngeal Diseases , Pathology , General Surgery , Laryngoscopy , Larynx , Pathology , Retrospective Studies , Vocal Cords , PathologyABSTRACT
Objective To investigate the characteristics of breast neoplasms on contrast-enhanced ultrasonography(CEUS) and its clinical value.Methods Two hundred and twenty-five patients with breast masses unable to be diagnosed by conventional ultrasonography were examined with CEUS.The characteristics of these masses on CEUS were analyzed and compared with the results of pathology examination.Results The typical features of breast cancers on CEUS were enlarged maximum diameter of the lesions on CEUS compared to pre-contrast ( P ＜0.05),irregular shapes,heterogeneous distribution of contrast enhancement with perfusion defect or local retention of contrast signals,tortuous,massive or penetrating vessels rapidly entering and exporting from the lesions.The sensitivity and specificity of perfusion defect for breast cancer on CEUS were 89.0％ and 91.8％,respectively; the sensitivity and specificity of local retention of contrast signals for breast cancer on CEUS were 93.4％ and 92.5％,respectively.Conclusions It is valuable for CEUS in the diagnosis and differential diagnosis of breast neoplasms clinically.
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Objective To identify the blood perfusion characteristics of different kinds of liver cancer and individualize interventional treatment models by color Doppler ultrasound(CDUS) and contrast-enhanced ultrasonography (CEUS). Methods The blood perfusion characteristics of 315 patients with liver cancer comfirmed by pathology were analyzed and classified using CDUS and CEUS. Individual interventional therapy models were selected based on the classification. Therapeutic effects were evaluated by EUS,contrast-enhanced CT(CECT) and DSA simultaneously. Results Liver cancer can be classified by the blood perfusion characteristics from CEUS examination. The individualized interventional treatment models were selected and evaluated according to the characteristics:①Solitary small HCC of diameter ≤3 cm group were treated via percutaneous ethanol injection(PEI),radiofrequency(RF) or percutaneous microwave coagulation therapy(PMCT). Necrosis rates of the lesions were 95.0% - 97.9%, 1 and 3 years survival rates were 98.0% and 87.8% ,respectively. ②Diameter ≤5 cm and lesions ≤3 group were treated with RF or PMCT combined PEI. Necrosis rates of the lesions were 93.7% - 94.8% ,1 and 3 years survival rates were 89.8% and 81.4% ,respectively. ③Diameter ＞5 cm and hypervascular tumor main fed by the hepatic artery group were treated with TACE,PEI combined RF or PMCT. Necrosis rates of the lesions were 71.4% - 73.8%, 1 and 3 years survival rates were 66.2% and 47.6%, respectively. ④ Diameter ＞5 cm and hypervascular tumor fed by double blood supply or accompanied by portal vein tumor thrombus group were treated with selective portal vein embolization(SPVE) based on the above treatments. Necrosis rates of the lesions were 53.3% - 55.6%, 1 and 3 years survival rates were 64.7% and 40.0%, respectively. Conclusions Classifying the blood perfusion characteristics and choosing individualized interventional treatment models by CEUS are of important clinical significance in non-surgical treatment of liver cancer.
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OBJECTIVE@#To investigate the therapeutic effect of obstructive sleep apnea hypopnea syndrome (OSAHS) by modified uvulopalatopharyngoplasty (UPPP).@*METHOD@#Forty-nine cases of OSAHS were treated by modified UPPP, and followed-up on 6 months, 1 year and 2 years after operation and carried out polysomnography (PSG) every time.@*RESULT@#Therapeutic effect was evaluated by standard of Hangzhou (2002) . In 6 months, symptoms of snore, breath holding, headache and lethargy disappeared or reduced obviously, the total effective rate was 100%. In 12 and 24 months, the effective rate was 95.92% and 91.84% respectively.@*CONCLUSION@#This operation can enlarge venting area of palatopharyngeal cavity effectively and keep density of soft palate as well as the normal function of pharyngeal mucous membrane, and can also elevate operative effect and decrease postoperative complications.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Otorhinolaryngologic Surgical Procedures , Methods , Palate , General Surgery , Palate, Soft , General Surgery , Pharynx , General Surgery , Sleep Apnea, Obstructive , General Surgery , Treatment Outcome , Uvula , General SurgeryABSTRACT
OBJECTIVE@#To present the experience of nasal reconstruction with forehead flap.@*METHOD@#nasal reconstruction with forehead flap were applied in eight nasal carcinoma cases after operation and 5 nasal trauma cases with defects.@*RESULT@#These forehead flaps were alive in all patients, all incision healed in I stage, no post operative complications were found. The shapes of nose were satisfactory, there were no recurrence of tumor during 1 to 17 year follow up.@*CONCLUSION@#The method can be clinically applied for its simple procedure, reliable flap's blood supply, high survival rate and satisfied result.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Forehead , General Surgery , Nose , Wounds and Injuries , General Surgery , Rhinoplasty , Methods , Skin Transplantation , Surgical FlapsABSTRACT
OBJECTIVE:To study the actions of seabuckthorn oil emulsion against chronic atrophic gastritis and gastic ulcer in rats.METHODS:Chronic atrophic gastritis and gastric ulcer models were established in rats and mice and the antiulcer and anti-chronic atrophic gastritis actions of seabuckthorn oil emulsion were determined.RESULTS:Seabuckthorn oil emulsion could obviously prevent gastric ulcer and chronic atrophic gastritis induced by deoxycholic acid and stress and could decrease the index of acute gastric ulcer caused by ligature of pylorus in rats and could oppose the ulcer induced by indomethacin-ethanol significantly in mice.CONCLUSION:The results suggest that the antiulcer and anti-chronic atrophic gastritis actions of seabuckthorn oil emulsion may be related with its protection of the gastric mucosal barrier and neutralization of acid.
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Objective To study the chemical constituents of Ophiorrhiza rosea.Methods The chemical constituents in O.rosea were extracted with 90% methanol,isolated and purified by column chromatography on silica gel,alumina gel,MCI gel,and macroporous resin adsorption.All the compounds were identified based on spectral analyses(MS,1H-NMR,and 13C-NMR).Results Eleven compounds were isolated from O.rosea.They were characterized as Harman(Ⅰ),2-hydroxy-3-hydroxymethylanthraquinone(Ⅱ),1hydroxy-2-hydroxymethylanthraquinone-3-O-?-D-glucoside(Ⅲ),1-hydroxy-2-hydroxymethylanthraquinone-3-O-?-D-primeveroside(Ⅳ),ursolic acid(Ⅴ),3?,19,24trihydroxy-12-ursen-28-oic acid(Ⅵ),19,23-dihydroxy-3-oxo-12-ursen28-oic acid(Ⅶ),3?,24-dihydroxy-12-oleanen-28-oic acid(Ⅷ),3,20-epoxy-3?,16-dihydroxy-15-oxo-7-pimaren-19,6-olide(Ⅸ),?-stigmasterol-3-O-?-D-glucoside(Ⅹ),and ?-sitosterol(Ⅺ).Conclusion This is the first report on the chemical constituents of O.rosea to find that it contains plentiful alkaloid Harman,multiform of triterpenes and anthraquinones.