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Objective:To evaluate the efficacy of Peiyuan Kangai Decoction combined with acupuncture in the treatment of advanced liver cancer with qi deficiency and blood stasis syndrome.Methods:Randomized controlled trial. From May 2019 to May 2021, 162 advanced liver cancer patients with qi deficiency and blood stasis syndrome in Shizhong District Cancer Hospital of Leshan were randomly divided into three groups by random drawing method, with 54 in each group. All patients were given FOLFOX4 chemotherapy regimen. Based on the chemotherapy, the 1st control group was given Peiyuan Kangai Decoction, and the 2nd control group was given acupuncture therapy, and the combined group was given decoction and acupuncture therapy. All three groups were treated for 6 weeks. Traditional Chinese Medicine syndrome score was performed before and after treatment, Piper fatigue scale was used to evaluate the fatigue degree of patients. Vimentin (VIM), Golgi transmembrane glycoprotein 73 (GP73) and chemokine ligand 1 (CXCL1) were determined by ELISA. The adverse reactions during treatment were observed and the clinical efficacy was evaluated.Results:The combined group showed the response rate was 61.11% (33/54), the disease control rate was 72.22% (39/54), the 1st control group showed the response rate was 40.74% (22/54), the disease control rate was 53.70% (29/54), and the 2nd control group showed the response rate was 38.89% (21/54), and the disease control rate was 51.85% (28/54). The response rate and disease control rate of the combined group were significantly higher than either the control group 1 and 2 ( χ2 values were 6.59, 5.68, respectively, and P values were 0.037, 0.043, respectively). After treatment, the scores of liver swelling and pain, fatigue and shortness of breath, anorexia, sallow and emaciation in the combined group were significantly lower than those in the control group 1 and the control group 2 ( F values were 13.90, 15.69, 13.20, 10.55, respectively, P<0.01); the scores of emotions, feeling, behavior and cognition were significantly lower than those in the control group 1 and control group 2 ( F values were 49.55, 27.42, 19.69, 20.55, respectively, P<0.01). After treatment, the levels of serum VIM [(52.54±6.69) ng/L vs. (61.29±7.89) ng/L, (65.11±7.92) ng/L, F=39.63], GP73 [(19.72±3.90) ng/L vs. (24.42±4.23) ng/L, (25.12±4.76) ng/L, F=25.05], CXCL1 [(3.12±0.72) ng/L vs. (4.85±0.95) ng/L, (4.98±0.91) ng/L, F=77.67] in the combined group were significantly lower than those in the control group 1 and the control group 2 ( P<0.01). During the treatment, the incidence of toxic and side effects in the combined group was 18.52% (10/54), the control group 1 was 27.78% (15/54), and the control group 2 was 24.07% (13/54). There was no statistically significant difference in the incidence of toxic and side effects among the three groups ( χ2=1.31, P=0.520). Conclusion:On the basis of FOLFOX4 chemotherapy, combined therapy with Peiyuan Kangai Decoction and acupuncture treatment can improve the symptoms and fatigue of patients with advanced liver cancer, reduce the levels of serum VIM, GP-73, CXCL1, improve the efficacy safely.
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Objective:To explore the dosimetry difference between volumetric modulated arc therapy (VMAT) and tomo direct (TD) in tumor bed simultaneous push radiotherapy after left breast-conserving surgery, and to provide more dosimetry reference for clinic.Methods:A total of 22 patients with left breast cancer who underwent simultaneous quantitative radiotherapy after breast-conserving surgery were selected from the Department of Radiation Oncology, Yunnan Cancer Hospital from December 2018 to June 2020. The localized CT images and target organs at risk and other structural data were collected. Two radiotherapy plans, VMAT and TD, were designed for the same patient, and the dosimetry differences of target areas and organs at risk were compared and analyzed between the two groups.Results:In terms of target dosimetry, there were statistically significant differences in the D 2% [ (59.99±0.19) Gy vs. (59.55±0.51) Gy, t=4.09, P<0.001], D 98% [ (57.19±0.08) Gy vs. (57.46±0.22) Gy, t=-5.10, P<0.001], conformal index (CI) (0.76±0.05 vs. 0.58±0.13, t=8.19, P<0.001) and homogeneity index (HI) (0.05±0.00 vs. 0.04±0.01, t=4.89, P<0.001) of the planning gross tumor volume (PGTV) between VMAT and TD plans. However, there was no statistically significant difference in the D 50% [ (58.73±0.10) Gy vs. (58.73±0.24) Gy, t=-0.03, P=0.974]. There were statistically significant differences in the D 50% [ (52.21±0.33) Gy vs. (53.00±0.72) Gy, t=-4.81, P<0.001], D 98% [ (48.44±0.43) Gy vs. (49.09±0.21) Gy, t=-6.80, P<0.001], CI (0.83±0.06 vs. 0.67±0.06, t=10.52, P<0.001) and HI (0.20±0.01 vs. 0.19±0.01, t=8.75, P<0.001) of the planned target volume (PTV) between the two plans. However, there was no statistically significant difference in the D 2% [ (59.01±0.45) Gy vs. (59.00±0.48) Gy, t=0.22, P=0.830]. In terms of organs at risk, there were statistically significant differences in the V 20 [ (18.81±2.86) % vs. (22.03±1.91) %, t=-5.36, P<0.001] and D mean [ (11.66±1.32) Gy vs. (12.85±1.46) Gy, t=-4.10, P=0.007] of left lung, V 5 [ (5.70±2.90) % vs. (0.30±0.13) %, t=16.44, P<0.001] and D mean [ (2.45±0.29) Gy vs. (0.43±0.14) Gy, t=9.09, P<0.001] of right lung, D mean [ (3.22±0.72) Gy vs. (1.69±0.80) Gy, t=5.41, P<0.001] of right breast, D 2% [ (5.37±1.97) Gy vs. (0.46±0.09) Gy, t=11.75, P<0.001] of cord between VMAT and TD plans. There were no significant differences in the V 5 of left lung [ (53.00±5.99) % vs. (50.00±7.69) %, t=1.91, P=0.061], V 5 of right breast [ (11.51±4.60) % vs. (8.06±3.49) %, t=1.59, P=0.120], V 30 [ (1.49±0.69) % vs. (1.51±0.71) %, t=-0.06, P=0.952] and D mean [ (3.99±0.97) Gy vs. (3.90±1.03) Gy, t=0.56, P=0.581] of heart between the two plans. Conclusion:TD and VMAT can meet the clinical dosimetry requirements for patients with left breast cancer after breast-conserving surgery. However, the two techniques have their own characteristics. VMAT has better conformity and TD has better uniformity. TD is significantly better than VMAT in protecting the right lung, right breast and spinal cord of healthy organs at risk. VMAT is better in protecting the left lung. Both VMAT and TD basically achieve the same protection for heart.
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Objective:To compare the dosimetric characteristics of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) after left breast conserving surgery.Methods:Twenty-four patients with left breast cancer after breast-conserving surgery who were admitted to the Department of Radiation Oncology of Tumor Hospital of Yunnan Province from May 2016 to May 2019 were selected. The HT plan and the VMAT plan were designed for the same patient. The target dose and the dose volume parameters of organs at risk were compared and analyzed in the two radiotherapy plans.Results:There were significant differences in the D 2% [(59.68±0.46) Gy vs. (60.06±0.20) Gy, t=-4.229, P<0.001], D 98% [(57.46±0.44) Gy vs. (57.20±0.07) Gy, t=2.912, P<0.001], conformity index (CI) (0.80±0.05 vs. 0.76±0.04, t=4.079, P<0.001) and homogeneity index (HI) (0.04±0.01 vs. 0.05±0.00, t=-5.505, P<0.001) of the planning gross tumor volume (PGTV) between the HT and VMAT plans. However, there was no significant difference in the D 50% [(58.77±0.46) Gy vs. (58.75±0.11) Gy, t=0.179, P=0.859]. There were significant differences in the D 50% [(51.99±0.39) Gy vs. (52.39±0.36) Gy, t=-5.278, P<0.001], D 98% [(49.46±0.29) Gy vs. (48.35±0.46) Gy, t=9.538, P<0.001] and HI (0.19±0.01 vs. 0.21±0.01, t=-7.538, P<0.001) of the planned target volume (PTV) between the two plans. However, there were no significant differences in the D 2% [(59.13±0.64) Gy vs. (59.09±0.46) Gy, t=0.511, P=0.614] and CI (0.83±0.04 vs. 0.82±0.04, t=1.637, P=0.115). In terms of organs at risk, there were significant differences in the V 5 [(57.90±1.42)% vs. (52.40±5.74)%, t=4.812, P<0.001], V 20 [(22.40±2.17)% vs. (18.40±3.16)%, t=5.573, P<0.001] and D mean [(12.71±0.55) Gy vs. (11.46±1.26) Gy, t=4.963, P<0.001] of left lung, D mean of right lung [(3.42±0.27) Gy vs. (2.49±0.24) Gy, t=13.310, P<0.001], D mean of right breast [(4.41±0.50) Gy vs. (3.12±0.65) Gy, t=10.326, P<0.001], V 30 [(0.55±0.37)% vs. (1.24±1.11)%, t=-4.020, P=0.001] and D mean of heart [(4.68±0.62) Gy vs. (3.83±0.88) Gy, t=7.335, P<0.001], D mean of left atrium [(2.53±0.31) Gy vs. (2.16±0.28) Gy, t=5.488, P<0.001], D mean of right atrium [(2.77±0.43) Gy vs. (2.20±0.30) Gy, t=7.103, P<0.001], D mean of right ventricle [(5.10±0.72) Gy vs. (3.72±0.94) Gy, t=9.802, P<0.001] and D 2% of spinal cord [(14.79±2.73) Gy vs. (5.42±2.23) Gy, t=14.788, P<0.001] between HT and VMAT plans. There was no significant difference in the D mean of left ventricle [(5.10±1.19) Gy vs. (4.80±1.54) Gy, t=1.250, P=0.224]. Conclusion:Both the HT plan and the VMAT plan can meet the treatment requirements. The HT plan can provide better target area conformity and dose uniformity. The VMAT plan has more advantages in terms of organs at risk. The HT plan shows an advantage only in exposure to high-dose area.
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Objective To investigate the role of Tmubl protein in liver cell proliferation. Methods Using silenced lentivirus (LV)-Tmubl vector, over-expression LV-Tmubl vector, and corresponding empty vectors to transfect rat’s liver cell line BRL-3A to obtain stable transfected cells, which bear the expression of Tmubl protein as detected by Western blotting, cell proliferation with MTT, and cell cycle with flow cytometry. Results The Tumbl protein expression in the hepatocytes transfected by LV-Tmubl was increased significantly and that by LV-Tmubl-RNAi decreased significantly, with a statistically significant difference compared with normal hepatocytes (P<0.01). The proliferation was fastest in hepatocytes transfected by LV-Tmubl and slowest in those by LV-Tmubl-RNAi, and the difference was statistically significant (P<0.01). The G2+S phase was longer in hepatocytes transfected by over-expression LV-Tmubl vectors than in those by silenced LV-Tmubl vectors, and the difference was statistically significant (P<0.01). Conclusion Tmubl protein can promote the hepatocyte proliferation in BRL-3A cell line.
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@#Objective To investigate the effects of transcranial direct current stimulation (tDCS) on motor function of upper limbs of stroke patients. Methods 80 stroke patients were randomly divided into experimental group and control group. Both groups accepted routine rehabilitation, while the experimental group accepted anodal stimulation, and the control group received sham stimulation. They were assessed with Brunnstrom stages of arms and hands, Fugl-Meyer Assessment (FMA) of upper extremities, Action Research Arm Test (ARAT), Motor Assessment Scale (MAS) and modified Barthel Index (MBI) before and 1 month after treatment. Results All the scores improved in both groups after treatment (P<0.05), and improved more in the Brunnstrom stages of arms and hands, FMA, ARAT in the experimental group than in the control group (P<0.05). Conclusion tDCS may promote the recovery of arms and hands function of stroke patients.
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Objective To investigate the interaction of Tmub1 and securin protein after partial hepatectomy. Methods A total of 30 adult male SD rats were randomly divided into 3 groups (10 each) according to the time after hepatectomy, i.e, 0, 24 and 48 h. Partial hepatectomy was performed in the rats in the first group, and then the primary hepatocytes were directly harvested by liver perfusion. Partial hepatectomy was also performed in the rest two groups at postoperative 24 and 48 h. Then the primary hepatocytes were also harvested respectively after liver perfusion. One part of primary hepatocytes was cultured for one night and for the observation of the colocalization of Tmub1 and securin protein with immunofluorescence. The other part of hepatocytes were used for co-immunoprecipitation and Western blotting to detect the expression of protein Tmub1/securin. Results Immunofluorescence and confocal laser scanning microscopy showed that there were almost no Tmub1 and securin proteins in the nucleus 0 h after liver resection, while a great amount of Tmub1/securin proteins were found to be co-localized in the nucleus 24 and 48 h. Co-immunoprecipitation and Western blotting showed that the expression of Tmub1/securing protein significantly enhanced in 24-48 h after operation compared with that at 0 h (P0.05). Conclusion Tmub1 hardly combines with securin protein in normal hepatocytes, but it combines with securin protein when it migrates from cytoplasm into nucleus after hepatectomy, thus inhibiting the proliferation process of hepatocytes.
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Objective: To observe the effect of glucocorticoid inhalation on the clinical symptoms and pulmonary fibrosis index in ARDS patients.
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[Objective] To sum up the clinical experience of treating nasopharyngeal carcinoma with TCM syndrome differentiation by professor Piao Bingkui. [Method] By analyzing the idea of Piao's therapy and medication of the proven case, it elaborates Pro. Piao Bingkui's clinical experience on using Chinese herbs, supporting the health and strengthening the root, anti-cancer and detoxification, to treat nasopharyngeal carcinoma. [Results] Pro. Piao Bingkui adepted at long-term maintenance therapy of TCM, which relieved the patient's clinical symptoms, and improved the quality of life significantly, and achieved satisfactory clinical outcome, according to the patient's previous treatment, the condition changes. [Conclusion] Pro. Piao Bingkui treated nasopharyngeal carcinoma depending on the different courses of individual, who used the methods of supporting the health and strengthening the root, anti-cancer and detoxification, could reduce the radiotherapy and chemotherapy toxicity, improve the body's resistance to disease and reduce the recurrence rate. It has important clinical significance.
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<p><b>OBJECTIVE</b>To summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment for adult refractory cardiogenic shock.</p><p><b>METHODS</b>From January 2003 to January 2011, patients with refractory cardiogenic shock required veno-arterial ECMO by failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury, advanced malignancies and multiple organ failure were excluded. Patients were divided into weaned group (n = 31) and not weaned group (n = 23) according to the ECMO weaning.</p><p><b>RESULTS</b>The duration of ECMO was 24.16 (14.12, 56.75) hours. Twenty-two out of 31 patients in the weaned group survived and were discharged, 9 patients died after successfully weaned from ECMO (5 due to multisystem organ failure, 2 due to reoccurred cardiogenic shock, 1 due to infectious shock and 1 due to disseminated or diffuse intravascular coagulation). Pre-ECMO mean arterial pressure, ejection fraction, the duration of ECMO were significantly higher while pre-ECMO blood lactate [(8.64 ± 3.17) vs. (14.44 ± 2.52) , P < 0.01], the duration of ROSC [ (16.70 ± 5.29) vs. (35.64 ± 5.89), P < 0.01] and multisystem organ failure [0 vs. 17.4% (4/23) , P < 0.05] were lower in weaned group than in not wean group.</p><p><b>CONCLUSIONS</b>ECMO is an effective mechanical assistant therapy strategy for adult refractory cardiogenic shock patients. Timely applying this strategy on suitable patients is crucial for the success of ECMO. Cardiac function and reversibility of heart failure are key factors determine the fate of weaned or not weaned ECMO in adult refractory cardiogenic shock patients.</p>
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Adult , Female , Humans , Male , Middle Aged , Extracorporeal Membrane Oxygenation , Retrospective Studies , Shock, Cardiogenic , TherapeuticsABSTRACT
Objective To master of the characteristics of development and variation in plague natural foci of Marmota sibirica, and to analyze the plague monitoring results from 2004 to 2008. Methods From May to September every year, we monitored plague in Manzhouli, Chenbaerhuqi, Xinbaerhuzuoqi, Xinbaerhuyouqi,Ewenkeqi and Yakeshi city. The monitored area was 20 000 - 40 000 hm2 in every county. The density of Marmota,ground squirrel and moonlighting rats was surveyed by path method, one-day bow-clip method and a clamp was placed every five meters, respectively. The classification and identification of ectoparasite fleas were done by using low power lens. The fleas in the ground squirrel hole were collected by flannel rubber stick, then classified and identified. According to National Standard of Plague Diagnostic Criteria(GB 15991-1995), the collected rats and fleas were detected by isolation and cultured Yersinia pestis, the serums of collected rats were tested by indirect hemagglutination test. Results In five years, the density of Marmota and ground squirrel was 0.010/hm2 and 0.602/hm2, respectively. The capture rate of moonlighting rats was 2.69％ (258/9600). The flea infection rate of Marmota was 17.54％(10/57) and the fleas index was 2.54. The fleas infection rate of ground squirrel was 28.40％(213/750) and the fleas index was 1.01. Flea infection rat of ground squirrel hole was 5.60％(46/822) and the fleas index was 0.17. The total number of various hosts of Yersinia pestis detected was 1351, the groups number of the variety of cultured fleas was 127, and the pathogen test results were negative. The number of serum tested was 1064, positive number was 43, and the detection rate was 4.04％(43/1064). The highest positive titer was 1 : 1280. Other than 2006, the remaining four years were found positive for blood clotting material; positive serum was found in a total of three regions, they were Manzhouli, Xinbaerhuzuoqi, and Xinbaerhuyouqi; and 30, 12 and 1 copies of hemagglutination-positive sera were detected. Conclusions The epidemic of plague natural foci of Marmota sibirica is in a active state, and gradually expands the scope. We must continue to strengthen the inspection of the bacteria, bearing in mind the replacement of the region's main host, make every effort to prevent and control of human plague.
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<p><b>OBJECTIVE</b>To evaluate the effectiveness and safety of holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP)/open prostatectomy (OP) in the treatment of bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We searched Medline, Cochrane Library, Embase, Wanfang and CBM for randomized controlled trials (RCT) comparing HoLEP with TURP/OP. Comparable data were extracted from eligible studies and pooled for meta-analysis using RevMan5.1.</p><p><b>RESULTS</b>Nine RCTs were included in this study, 6 comparing HoLEP with TURP, and the other 3 comparing HoLEP with OP. Meta-analysis showed that, compared with TURP, HoLEP was associated with shorter hospital stay and catheterization time, less hemoglobin loss, longer operative time, and better improvement in international prostate symptom score (IPSS) , peak urinary flow rate (Qmax) and post void residual (PVR) , but the incidences of postoperative urethral stricture and urinary incontinence had no statistically significant difference between the two. Compared with OP, HoLEP showed shorter hospital stay and catheterization time, a lower rate of blood transfusion, longer operative time, and removal of fewer tissues, but the two procedures exhibited no significant differences in either the improvement of IPSS and Qmax or the incidence of urethral stricture.</p><p><b>CONCLUSION</b>HoLEP is a minimally invasive technique, safe and highly effective for the treatment of BOO secondary to BPH, with its advantages of lower peri-operative morbidity and faster recovery over TURP and OP. However, more high-quality RCTs with larger sample sizes and longer follow-ups need to be carried out to obtain better evidence.</p>
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Humans , Male , Holmium , Laser Therapy , Prostatic Hyperplasia , General Surgery , Randomized Controlled Trials as Topic , Transurethral Resection of Prostate , MethodsABSTRACT
Objective To summarize the characteristic findings on chest radiography and spiral CT of anomalous systemic arterial supply to normal basal segments of the left lower lobe of the lung.Methods Five patients with anomalous systemic arterial supply to normal basal segments of the left lower lobe of the lung were retrospectively reviewed.Chest radiography,and contrast-enhanced spiral CT scan were analyzed. Results On posteroanterior chest radiographs,the findings in 5 cases of this anomaly were all shown as a retrocardiac mass,narrowing lower lobar pulmonary artery shadow,and without normal lower lobar pulmonary artery branches but there were dilated abnormal markings in left lower lung zone.On contrast- enhanced spiral CT scans,the involved left lower lobe of the lung had mild volume loss but normal bronchial trees in all 5 cases and areas of ground-glass opacity in 2 cases.The absence of normal left lower lobar pulmonary artery distal to the origin of superior segmental artery,anomalous systemic artery originating from the descending aorta,diffuse dilatation of the systemic arterial branches distributed in the basal segments of the left lower lobe were also found in all the patients.One patient who underwent angiography had similar vessel features with spiral CT.Conclusion There are some characteristic findings on chest radiography in this anomaly.the contrast-enhanced spiral CT scans are important in diagnosing and avoiding invasive angiography and life-threatening lung biopsy.