ABSTRACT
Objective:To evaluate the efficacy of modified self-made Qingxin Buqi Pinggan Decoction combined with atomoxetine hydrochloride in the treatment of attention deficit hyperactivity disorder (ADHD).Methods:Randomized controlled trial. A total of 200 children with ADHD admitted to our hospital from January 2020 to January 2022 were selected as observation subjects by prospective cohort study, and were divided into two groups according to the random number table method. The control group was given oral administration of atomoxetine hydrochloride capsules, and the observation group was given self-made Qingxin Buqi Pinggan Decoction on the basis of the control group. Both groups were treated continuously for 3 months. Before and after treatment, the Traditional Chinese Medicine symptoms were scored, and the core symptoms of the children were evaluated by Swanson Nolan and Pelham-versionⅣ (SNAP-Ⅳ), and the hyperactivity tendency was assessed by Parent Symptom Questionnaire (PSQ). The serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels were measured by chemiluminescence immunoassay. Adverse reactions during treatment were observed and clinical efficacy was evaluated.Results:The total effective rate was 97.0% (97/100) in observation group and 88.0% (88/100) in control group ( χ2=5.84, P=0.016). After treatment, the scores of restlessness, hyperactivity, unsteadiness, emaciation, lusterless complexion and restless sleep in the observation group were significantly lower than those in the control group ( t=17.90, 11.79, 10.01, 23.27, 11.79, 12.03, P<0.01). The scores of impulsivity factor, learning factor, hyperactivity factor, behavior factor, psychosomatic factor and anxiety factor were significantly lower than those in the control group ( t=4.65, 42.83, 10.01, 41.89, 39.42, 18.30, P<0.01). The scores of attention deficit, hyperactivity-impulsivity and behavior performance were significantly lower than those in the control group ( t=11.68, 9.69, 28.42, P<0.01). After treatment, the levels of serum COR [(337.26±17.22) nmol/L vs. (275.51±15.49) nmol/L, t=26.66] and ACTH [(24.47±1.12) ng/L vs. (19.23±1.43) ng/L, t=28.85] were significantly higher in observation group than those in the control group ( P<0.01). During treatment, the incidence rate of adverse reactions was 6.0% in observation group and 5.0% in control group ( χ2=0.10, P=0.756). Conclusion:Modified self-made Qingxin Buqi Pinggan Decoction combined with atomoxetine hydrochloride can improve the clinical symptoms of children with ADHD, reduce the degree of hyperactivity disorder, increase the levels of serum COR and ACTH, and enhance the clinical efficacy.
ABSTRACT
Objective To compare the difference of dose distribution between inverse planning simulated annealing (IPSA) and hybrid inverse treatment planning and optimization (HIPO) in 3D brachytherapy plan of cervical cancer,and to provide evidence for selection of reverse planning optimization method for cervical cancer brachytherapy.Methods From Dec 2016 to May 2017,totally 43 cases of patients with cervical cancer radical surgery were selected.Original IPSA brachytherapy treatment plan optimization was applied to all cases.Based on the information of original image,IPSA and HIPO plans were established according to the same initial conditions.Parameters of Dg0,D100,V100％,Homogeneity Index (HI),and conformal index (CI) of the bladder,rectum and sigmoid D2 cm3 data for High-Risk Clinical Target Volume (HR-CTV) were assessed.Results There was no statistically significant difference in D90,D100 and CI for HR-CTV between the two groups.But the V100％ of HR-CTV in HIPO group was significantly higher than that in IPSA group [(87.72 ±0.49)％ vs.(85.01 ± 0.55)％,t =2.54,P ＜0.05].Furthermore,HI in HIPO group was (0.51 ±0.08),which was higher than that in IPSA group (0.42 ± 0.06),and the difference was statistically significant (t =3.02,P ＜ 0.05).Compared with IPSA,bladder D2 cm3 and rectum D2 cm3 [(3.04 ± 0.37) Gy] for HIPO plan were lower [(3.42 ± 0.17) Gy vs.(3.57 ± 0.28) Gy,(3.04 ± 0.37) Gy vs.(3.57 ± 0.28) Gy],which had reached statistical significance (t =0.27,0.19,P ＜ 0.05).There was no statistical significance in the D2 cm3 dose of sigmoid.Conclusions In the treatment of cervical cancer,better target area HI and less irradiated dose of bladder and rectum can be obtained by HIPO optimization than IPSA optimization.
ABSTRACT
A new transformation method for follow-up coordinate system is used and a matrix equation for transforming spatial transporting coordinate of scattering photons is given. The equation has recursion form and only relates to multiplication and will not lead to overflow in calculation. The equation is applied to Monte Carlo simulation in the light propagation in bio-tissues. The results show it can effectively save CPU time and improve simulation efficiency. The results are also in good agreement with the results from the traditional method.