ABSTRACT
Objective To observe the clinical efficacy of acupoint thread embedding plus thunder-fire moxibustion in treating hyperlipidemia due to spleen-kidney yang deficiency. Method Sixty patients with hyperlipidemia due to spleen-kidney yang deficiency were randomized into a treatment group and a control group, 30 cases each. The treatment group was intervened by acupoint thread embedding plus thunder-fire moxibustion, while the control group was intervened by oral administration of Atorvastatin calcium tablets. After 8-week treatment, changes in the serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and traditional Chinese medicine (TCM) syndrome score were observed in the two groups, and the clinical efficacies were compared. Result The blood lipids indexes (TC, TG, HDL-C and LDL-C) and TCM syndrome score were significantly changed after the treatment in both groups (P<0.05). After the treatment, the blood lipids indexes and TCM syndrome score of the treatment group were insignificantly different from those of the control group (P>0.05). The total effective rate was 90.0％ in improving the blood lipids in the treatment group, versus 93.3％ in the control group, and the between-group difference was statistically insignificant (P>0.05). The total effective rate was 83.3％ in improving the TCM syndrome score in the treatment group versus 63.3％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Acupoint thread embedding plus thunder-fire moxibustion is an effective method in treating hyperlipidemia due to spleen-kidney yang deficiency.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical features and treatment of multifocal papillary thyroid carcinoma (PTC).</p><p><b>METHODS</b>A retrospective survey was carried out in 648 patients with PTC who underwent surgery from January 1997 to December 2006. One hundred and sixty-eight cases of the patients presented with multiple tumor masses (> or = 2). The risk factors, including sex of the patients, age at diagnosis, family history of thyroid tumor, multiplicity and bilaterality of tumor, extra-thyroidal extension, lymph node involvement and other were analyzed between solitary PTC and multifocal PTC group.</p><p><b>RESULTS</b>The mean age of the patients was 42 years (range, 14 - 78 years), included 49 male and 119 female. Tumor foci were found in both thyroid lobes in 117 cases (69.6%). Patients with multifocal PTC were characterized by a higher ratio of male (P = 0.004), family history of thyroid tumor (P = 0.031), neck lymph node metastasis (P = 0.008) and extra-thyroidal extension (P = 0.001). However, solitary PTC tended to be with a higher rate of benign goiters in pathologic examination. In multifocal PTC group, male, neck lymphadenectasis, > or = 3 tumor masses or bilaterality of tumor tended to presented with larger tumor, more neck lymph node metastasis and extra-thyroidal extension; And a less malignant tumor in the cases detected with benign goiters in histological examination. By the end of 2007, 164 cases (97.6%) completed follow-up with a mean period of 46.1 months (range, 2 - 127 months), 5 died in the meantime. One patient has been followed-up for 16 months for suspect of lung metastases by chest X-ray. Recurrence occurred in 8 patients and were re-resected, 2 in remnant thyroid and 6 in neck lymph nodes. The overall 1-, 2-, 5-, and 10-year survival rate was 98.2%, 97.4%, 96.5% and 96.5%, respectively. American Joint Committee on Cancer (AJCC) stage was associated with prognosis significantly (chi(2) = 168.832, P = 0.000).</p><p><b>CONCLUSIONS</b>Multifocus is one of the clinical features of PTC and is more malignant than solitary PTC. Total thyroidectomy with central compartment neck dissection could be standard treatment. Lateral nodal dissection is not necessary except for the cases with lymph node metastasis. AJCC stage is still the best prognostic factor.</p>