Clinical Study of Modified Chushi Juanbitang Combined with Pedicle Vertebrotomy on Kyphosis of Ankylosing Spondylitis Due to Syndrome of Dampness-heat Obstruction / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Chushi Juanbitang combined with pedicle vertebrotomy on kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction. Method:The 90 cases were randomly divided into control group and observation group， 45 cases in each group. The patients in control group received pedicle vertebrotomy + <italic>Tripterygium</italic> glycosides， and the patients in observation group received pedicle vertebrotomy + modified Chushi Juanbitang. The treatment course was 6 months in both groups. Their bath ankylosing spondylitis disease activity index （BASDAI）， bath ankylosing spondylitis measure index （BASMI）， imaging index， traditional Chinese medicine syndromes， serum proinflammatory factor， anti-inflammatory factor， bone metabolism index ［bone-specific alkaline phosphatase （BALP）， tartrate resistant acid phosphatase isomer-5b （TRACP-5 b）， bone morphogenetic protein-2 （BMP-2）， osteocalcin （BGP）］， ossification related proteins ［bone morphogenetic protein-7 （BMP-7）， dickkopf-related protein-1 （DKK-1）， and tissue inhibitor matrix metalloproteinase-2 （TIMP-2）， sclerostin（SOST）］ were observed and detected. The clinical efficacy， recurrence rate and safety indexes were followed up for 12 months and compared. Result:The total effective rate was 97.73% （43/44） in the observation group， higher than 80.95% （34/42） in the control group （<italic>χ</italic>²=5.172， <italic>P</italic><0.05）. In the comparison with control group after treatment， the BASDAI， BASMI， imaging index， traditional Chinese medicine syndromes， proinflammatory factors， TRACP-5b， BMP-7 and TIMP-2 were lower in observation group （<italic>P</italic><0.05）， and the anti-inflammatory factors， BALP， BMP-2， BGP， DKK-1 and SOST were higher in observation group （<italic>P</italic><0.05）. During the follow-up for at least 12 months， the recurrence rate was 4.65% （2/43） in observation group， lower than 26.47% （9/34） in control group （<italic>χ</italic>²=4.261， <italic>P</italic><0.05）. There was no significant difference in the incidence of postoperative complications between the two groups. The incidence of adverse reactions was 2.27% （1/44） in observation group， lower than 38.64% （17/44） in control group （<italic>χ</italic>²=5.763， <italic>P</italic><0.05）. Conclusion:Modified Chushi Juanbitang combined with pedicle vertebrotomy is effective in the treatment of kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction.

Efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of OSAHS with soft palate oropharyngeal obstruction / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Seventy-three patients(including 60 males and 13 females) with OSAHS admitted to the department of otorhinolaryngology of our hospital in recent two years were retrospectively analyzed. All the patients had velopharyngeal obstructionevaluated by electronic endoscopic Müller test and were divided into control group (34 cases) and observation group (39 cases). The patients in the control group were performed modified uvulopalatopharyngoplasty, while those in the observation group were performed relocation and expansion pharyngoplasty by suspension sutures.The scores of ESS, AHI and LSaO2 before and after treatment were collected and compared. Results: The total effective rate of the observation group was 94.87%, which was significantly higher than 79.41% of the control group. The AHI was lower and LSaO2 value was higher (χ2=-1. 896,-1. 968,P<0.05)in the observation group. The sleeping symptoms and quality of life of the two groups were significantly improved. The ESS score of the observation group was decreased more significantly than that of the control group after treatment, and the difference was statistically significant (χ2=-1.451,P<0.05). The incidence of foreign body sensation in pharynx of the observation group (89.74%) was higher than that of the control group (55.88%), and the postoperative bleeding and postoperative recurrence rate (0.00%, 2.56%) was lower than that of the control group (8.82%, 14.70%)with statistical significance (χ2=4.738,4.249,4.119,P<0.05).The incidence of transient nasopharyngeal reflux in both groups was low and statistically insignificant (χ2=0.629,P>0.05). Conclusions: Preoperative strict screening of indications plays an important role in the selection of palatopharyngeal surgery methods and curative effect. Relocation and expansion pharyngoplasty by suspension sutures can improve the clinical efficacy of OSAHS with better safety and less recurrence.

Clinical Efficacy of Modified Chushi Huqianwan Combined with Core Decompression on Ⅰ, Ⅱ Stage Osteonecrosis of Femoral Head Due to Hot and Humid Syndrome / 中国实验方剂学杂志

Objective:To observe the efficacy of modified Chushi Huqianwan combined with core decompression on Ⅰ， Ⅱ stage osteonecrosis of femoral head due to hot and humid syndrome， and the effect on bone metabolism index ［osteocalcin （BGP）， bone morphogenetic protein-2 （BMP-2）， bone isoenzyme alkaline phosphatase （BALP）］， blood lipid ［apolipoprotein A （ApoA）， apolipoprotein B （ApoB）， apolipoprotein C3 （ApoC3）］， protein expression ［matrix metalloproteinase-2 （MMP-2）， matrix metalloproteinase-9 （MMP-9）， tissue inhibitor of matrix metalloproteinase-2 （TIMP-2）］. Method:A total of 90 cases were divided into control group and observation group， with 45 cases in each group. The control group was given core decompression + Xianling Gubao， while the observation group was given core decompression + modified Chushi Huqianwan for 6 months. The hip harris score （HHS）， lateral head index （LHI） and traditional Chinese medicine （TCM） syndrome were observed between two groups. The serum bone metabolic indices （BGP， BMP-2， BALP）， blood lipid （ApoA， ApoB， ApoC3）， protein expressions （MMP-2， MMP-9， TIMP-2） were detected between two groups. The clinical efficacy， adverse reaction and recurrence in 36-month follow-up were compared between two groups. Result:The total effective rate was 97.73% （43/44） in observation group， which was higher than 80.95% （34/42） in control group （χ2=5.915， P<0.05）. The recurrence rate was 4.65% （2/43） in observation group， which was lower than 35.29% （12/34） in control group （χ2=5.317， P<0.05） during the 36-month follow-up. HHS and LHI in observation group were significantly higher than those in control group （P<0.05）， and TCM syndrome score was significantly lower than that in control group （P<0.05）. Compared with control group after treatment， BGP， BMP-2， BALP， MMP-2 and MMP-9 in observation group were significantly increased （P<0.05）， whereas ApoA， ApoB， ApoC3， TIMP-2 were significantly decreased （P<0.05）. No obvious adverse reactions were observed during the treatment. Conclusion:Modified Chushi Huqianwan combined with core decompression can significantly improve clinical symptoms， bone metabolism indexes， blood lipid and protein expressions of patients with Ⅰ， Ⅱ stage osteonecrosis of femoral head due to hot and humid syndrome.

Protective effect of peperphentonamine injection through the otocyst against gentamicin- induced cochlear damage in guinea pigs / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the relationship of gentamicin-induced cochlear damage with autophagy-related protein LC3, beclin1, Na(+-)K(+-)2Cl(-) cotransporter (NKCC1) mRNA and endothelin-1 (ET-1), and investigate the protective mechanism of PPTA against gentamicin-induced cochlear damage.</p><p><b>METHODS</b>Sixty guinea pigs were randomly divided into control group (with saline and artificial perilymph injections), model group (with gentamicin and artificial perilymph injections), concurrent treatment group (with gentamicin and PPTA injections), model control group (with artificial perilymph injection 7 days after gentamicin injection) and delayed treatment group (with PPTA injection 7 days after gentamicin injection). Saline and gentamicin (160 mg/kg) were injected intraperitoneally, and artificial perilymph and PPTA were injected into the otocysts on a daily basis for 7 consecutive days. Hearing impairment of the guinea pigs was analyzed with ABR, and the protein expressions of beclin1 and LC3 in cochlear tissue were tested. The expression of NKCC1 mRNA was detected with RT-PCR, and the expression of ET-1 was detected immunohistochemically.</p><p><b>RESULTS</b>The ABR thresholds in the model group and model control group were similar (P>0.05) , but significantly higher than those in the other 3 groups (P<0.05); the threshold was significantly lower in concurrent treatment group than in delayed treatment group (P<0.05). Compared with those in the other 4 groups, the expressions of LC3 II, beclin1, and NKCC1 mRNA were significantly increased in the model group (P<0.05); and those in delayed treatment group were significantly lower than those in the model control group (P<0.05). The expressions of ET-1 in the Corti organ, striavascularis and spiral ganglion were significantly higher in the model group but significantly lower in the control group than those in the other 4 groups; ET-1 expression was significantly lower in delayed treatment group than in the model control group.</p><p><b>CONCLUSION</b>PPTA offers protection against gantamicin-induced cochlear damage in guinea pigs by inhibiting cell autophagy and suppressing of NKCC1 and ET-1 expressions. Early intervention with PPTA produces better therapeutic effect, suggesting that gantamicin causes irreversible injury of the auditory cells.</p>