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Objective:To explore and annalize the characteristics of Cao Yongqing's prescription characteristics and medication rules for treating constipation. Methods:To collect the TCM prescription by Professor Cao Yongqing for treating constipation from Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine from January 1, 2007 to December 31, 2017. The Traditional Chinese Medicine Inheritance Support System (V2.5) was used to analyze the treatment frequency, taste, decoction pieces combination and decoction pieces association. By using entropy clustering rules to analyze the main combination and clustering rules of new combined prescriptions. Results:A total of 561 prescriptions were included, involving 113 kinds of pieces. The top 5 picecs with high frequency were Zhishi, Houpo, Dangshen, Fuling and Chuanlianzi in order of frequency, and the meridians were mainly spleen meridians, stomach meridians and liver meridians. There were 25 combined pieces with high-frequency, and the top 3 were Zhishi and Laifuzi and Houpo, Zhishi and Houpo and Chuanlianzi, as well as Zhishi and Laifuzi and Houpo and Chuanlianzi. There were 18 core combinations and 9 new prescriptions, including 4 prescriptions (44.4%) for promoting qi, such as prescriptions composed of Qingpi, Quangualou, Chenpi, Houpo, Laifuzi, Shengma, Zhishi and Chuanlianzi; 2 prescriptions for invigorating the spleen and eliminating dampness (22.2%), such as prescriptions composed of Fuling, Shengdihuang, Foshou, Jinyinhua, Dangshen and Baizhu; 2 prescriptions (22.2%) for promoting blood circulation and removing blood stasis, such as Danshen, Guanghuoxiang, Moyao and Danggui, one prescription (11.1%) for nourishing yin and qi was composed of Shihu, Shouwuteng, Huangqi, Fuling and Foshou. Conclusions:Regulating spleen and stomach, regulating qi and eliminating dampness, and promoting blood circulation are the main ideas of Professor Cao Yongqing in treating constipation.
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Objective To compare the efficacy and safety of DOX (docetaxel + oxaliplatin + capecitabine) program with mFOLFOX6 (oxaliplatin + fluorouracil) program as neoadjuvant chemotherapy in locally advanced gastric cancer patients.Methods 72 patients who was diagnosed as local advanced gastric cancer in our hospital from October 2014 to December 2017,were treated by neoadjuvant chemotherapy,36 of which were mFOLFOX6,and 36 were DOX.After 3 cycles of chemotherapy,the clinical efficacy was determined and the adverse reactions were analyzed.Results In the 36 cases of mFOLFOX6 group,the clinical remission rate was 27.8％ (10/36),and the tumor control rate was 63.9％ (23/36).Among the 36 patients in the DOX group,the clinical remission rate was 36.1％ (13/36),and the tumor control rate was 75.0％ (27/36).The recent clinical efficacy of the two groups were not statistically significant (both P ＞ 0.05).The R0 cutting rate of mFOLFOX6 group was 66.7％ (24/36),and the DOX group was 77.8％ (28/36).There was no statistically significant difference between the R0 cut rate of the radical operation of the two groups (both P ＞ 0.05).The incidence of nausea,vomiting and leukocyte reduction in DOX group was significantly higher than that in the mFOLFOX6 group,and the difference was statistically significant (all P ＜ 0.05).Conclusions The combination of mFOLFOX6 and DOX is similar in the treatment of neoadjuvant chemotherapy in gastric cancer,but the incidence of gastrointestinal reaction and hematological toxicity in DOX scheme is higher.
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Objective To investigate the clinical significance and difference in the expression of endostatin and vascular endothelial growth factor (VEGF) in non-small cell lung cancer (NSCLC) patients with different response to recombinant human endostatin (rh-endostatin) combined with chemotherapy.Methods Serum levels of endostatin and VEGF in peripheral blood of 30 patients with stage Ⅳ NSCLC (NSCLC group) and 30 healthy controls (control group) were determined by enzyme-linked immunosorbent assay.Two cycles of chemotherapy combined with rh-endostatin were provided to NSCLC patients to evaluate the efficacy of the regimen.Simultaneously,serum levels of endostatin and VEGF were measured before and after treatment.Results The level of serum endostatin was (37.96 ± 9.01) ng/ml and (40.12 ± 12.11)ng/ml in NSCLC patients and healthy controls,respectively,which was lower in the former than that of the latter,without statistical difference (P ＞ 0.05).Furthermore,the level of serum VEGF was (127.98 ± 33.88) pg/ml and (36.33 ± 15.43) pg/ml in NSCLC patients and healthy controls,respectively,which was higher in the former than that of the latter,with statistical difference (t =13.48,P ＜ 0.05).Besides,levels of endostatin and VEGF in serum were not correlated with the sex,age,tumor pathological type and differentiation of NSCLC patients (P ＞ 0.05).After two cycles of chemotherapy combined with rh-endostatin treatment,the level of serum endostatin in partial response (PR) or stable disease (SD) patients was (76.22 ± 20.41) ng/ml,higher than that of progressive disease (PD) patients,which was (31.24 ± 13.09) ng/ml (t =7.143,P ＜ 0.05).In addition,the level of serum VEGF in PR or SD patients was (93.28 ± 21.33) pg/ml,which was lower than (155.81 ± 48.38) pg/ml of the PD patients (t =3.503,P ＜ 0.05).Conclusions The levels of endostatin and VEGF are associated with the efficacy of anti-angiogenesis combined with chemotherapy in NSCLC patients.
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Fecal incontinence is a common but refractory anorectal disorder,seriously affecting the quality of life of patients. Although there are many methods for the treatment of fecal incontinence, the efficacy is uncertain and the mechanism of action is not fully clear. This article summarizes several commonly used modeling method of typical fecal incontinence models at home and abroad, and explores in depth, laying the foundation for further studies on fecal incontinence.
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Deep post -anal space abscesses and horseshoe fistulas are one of the complicated anorectal dis-eases.Deep post -anal space is an important configuration in its suppurative process.The infection usually extends through the internal sphincter to deep post -anal space which is adjacent to the ischiorectal space.Its pathological characters promote surgical therapies.The modified Hanley procedure is the most commonly utilized technique with low recurrence rates and minimal anorectal dysfunction.
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Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.
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Humans , Abscess , Drainage , Rectal Fistula , Suture Techniques , SuturesABSTRACT
Objective: This study was to develop an experimental rat model of subcutaneous fistula induced by bacteria infection and treat it with thread-dragging therapy. Methods: A spring-gauze was surgically implanted into 24 male Sprague-Dawley rats' dorsal muscles, respectively, then mixed Staphylococcus aureus and Escherichia coli were injected into the spring-gauze. After 45 d, all the spring-gauzes were removed from the rats under anesthesia. X-ray and ultrasound were performed to assess the fistula tract. Each rat was examined by a fistula probe and four rats were randomly selected for histological assessment. The residual rats were randomly divided into two groups. Group A was treated with thread-dragging therapy, and group B was treated with fistulotomy. The healing time and body weight of the two groups were compared. Results: On the 45th day of the spring-gauze implantation, imaging assessment proved a tract with two openings in all rats and histological results proved that lumen and surrounding granulation tissue with epithelium were similar to the features of fistula in human beings. The mean healing time of rats in group A was shorter than that of the rats in group B (P<0.01). The body weight of rats in group A was heavier than that of the rats in group B on the 7th and 14th day after surgery, respectively (P<0.05). Conclusion: A rat model of subcutaneous fistula induced by mixed Staphylococcus aureus and Escherichia coli infection was successfully established. Traditional Chinese medicine thread-dragging therapy is less invasive and safer than fistulotomy.
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Objective To investigate basic fibroblast grow th factor (bFGF) and CDI05 in gastric carcinoma and its biological be-havior. Methods bFGF, microvessel density (MVD) and stomach cancer cell S phase fraction (SPF) in 60 samples from stomach cancer patients and 20 samples from normal stomach were detected with immunohistochemistry.. Apoptosis in stomach cancer was determined with TUNEL and apoptosis rate (AR) was calculated. Results bFGF protein expression, MVD and SPF in stomach cancer patients were obvi-ously higher than that normal health controls, but AR were lower, bFGF and MVD showed positive relationship with SPF, and negative with AR. Conclusion bFGF possibly increased the MVD state, promoted stomach cancer cell multiplication, suppressed stomach cancer cell ap-optosis.
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Objective: To observe the effects of mild moxibustion on angiogenesis and microcirculation in wound repair after operation of anal fistula, and to explore the mechanism of action. Methods: Seventy-two SD male rats were made to bear an "acute, open, bleeding, infected" wound surface and were divided randomly into mild moxibustion group, microwave group and control group (24 rats per group). The wound surfaces of the treatment groups were treated for 15 min with mild moxibustion or microwave medical instrument from the first day after operation, and the control group was not given any treatment. At the first, third, seventh and fourteenth days after operation (1, 3, 7 and 14 days of treatment), six rats in each group were sacrificed after examining the blood flow of the wound surface, and the samples of granulation tissues were collected. The numbers of CD34 and positive expression of vascular endothelial growth factor (VEGF) in granulation tissues were detected. Results: In the early and middle stages of wound healing, mild moxibustion could obviously increase the expression of VEGF, the number of CD34, and the blood flow of the wound surface. And the expression of VEGF, the number of CD34, and the blood flow of the wound surface began to increase at the third day, and reached the peak level at the seventh day, and then began to decrease. In the late stage of wound healing (day 14), mild moxibustion could decrease the expression of VEGF, the number of CD34, and decrease the blood flow of the wound surface. There were significant differences between the mild moxibustion group and the control group in the blood flow of the wound surface, the expression of VEGF and the numbers of CD34 in granulation tissues (P<0.05) after treatment, and except the number of CD34 at 14-day treatment, there were also differences between the mild moxibustion group and the microwave group. Conclusion: Mild moxibustion has better regulative actions on blood flow of the wound surface and the number of CD34 and positive expression of VEGF in granulation tissues, and can regulate microcirculation in wound surface and promote the wound healing.
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Background: Basic principles of clinical trials of nonpharmacologic treatment are similar to those of pharmacologic treatment, but its some special characteristics should be discussed. Objective: To explore the design characteristics of clinical surgery trial through the example of tunnel thread-drawing therapy for simple anal fistula. Design, setting, participants and interventions: The clinical trial was designed as a prospective, controlled, randomized multicenter trial. The patients came from Longhua Hospital, Yueyang Hospital of Integrated Traditional Chinese and Western medicine, and Affiliated Hospital of Jianxi University of Traditional Chinese Medicine. Stratified random was performed according to the subtype of anal fistula including low and high anal fistula. Full analysis set was applied to analyze the baseline data, and per protocol set was used in efficacy and safety analysis. The intervention was tunnel thread-drawing method. Classical therapy of thread-drawing method was employed as positive control. Main outcome measures: The primary outcomes were course of recovery and cure rate. Quality of life score was used as secondary outcome and anal maximum constriction pressure was considered as safety outcome. Results: Optimal efficiency testing method was used to estimate sample size. A total of 244 subjects were recruited and 236 subjects completed the trial. There was no significant difference in the cure rate of the low and high anal fistula between the treatment group and control group. There was a significant difference in the course of recovery in the patients with low and high anal fistula between treatment group and control group (P0.05). The trial showed that the tunnel thread-drawing therapy was significantly more effective than classical method for improving the anal sphincter function and patient satisfaction with treatment in the patients with high anal fistula. However the other items of quality of life in the two groups did not show significant difference. There was no any adverse event report in each group. There was no significant difference in the anal maximum constriction pressure in the treatment group before and after the operation. Conclusion: The trial shows that the tunnel thread-drawing therapy for simple anal fistula can shorten the course of recovery and improve the patients' quality of life. The training about surgical intervention and clinical implementation program is important in clinical surgery trial. Blind is absolutely difficult to implement and placebo cannot be used in this kind of trial.
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Abstract: There were more and more patients suffered from perianal abscess. The patient's condition will become even worse if the patients cannot be treated properly. Selecting proper operation method according to special condition is the key point of increasing curative effect, decreasing suffering and relapse rate and promoting quality of life of patients. The authors summarized operation methods, including abscess incision drainage, radical incision and thread-drawing, and staging incision and thread-drawing, etc. in treating perianal abscess in clinic.
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The thread-dragging therapy, as a new external treatment of traditional Chinese medicine, could eliminate pathogenic factors and restore the vital qi by promoting qi and activating blood circulation to advance tissue repair in treating refractory sinus tracts or fistulae. This article reviewed its origin and development, and introduced its use in treating refractory sinus tracts or fistulae.
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To observe the effects of Yiqi Kaimi Recipe (YQKMR), a traditional Chinese compound medicine, on gastrointestinal motility and neuropeptides in rats with colonic slow transit constipation.
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OBJECTIVE: To evaluate the efficacy and safety of thread-dragging through fistula method in treating patients with simple anorectal fistula. METHODS: In this multi-centered, prospective, and randomized controlled clinical trial, 244 patients with simple low or high anorectal fistula were randomly divided into study group (with the method of thread-dragging through fistula) and control group (with the method of incision or thread-drawing). The healing time and curative rate of anorectal fistula, and the integral calculus of clinical symptom and life quality evaluations before and after treatment were all examined. The maximal anal canal squeeze pressure was measured to compare the therapeutic safety between these two groups. The health economical benefits were also assessed to determine which therapeutic method was more economical. RESULTS: The curative rate of simple low and high anorectal fistula were of no significant differences between the study group and the control group. The healing time of simple low anorectal fistula in the study group and the control group were (22.26+/-8.67) d and (31.41+/-11.39) d respectively, while the healing time of simple high anorectal fistula in the study group and the control group were (24.73+/-8.15) d and (32.20+/-12.60) d respectively, and there revealed significant differences between these two groups. Each integral calculus of clinical symptom evaluation in the study group was not obviously different from those in the control group besides the integral calculus of anal sphincter function. The integral calculus of life quality between the study group and the control group of simple low anorectal fistula had no significant differences. The integral calculus of anal sphincter function and confidence in treatment in the study group of high anorectal fistula were better than those in the control group. The hospitalization expense of the study group was remarkably lower than that of the control group. The maximal anal canal squeeze pressure in the study group after treatment was not reduced obviously as compared with that in the same group before treatment, while it was decreased significantly in the control group after treatment as compared with those in the same group before treatment and in the study group after treatment. CONCLUSION: The method of thread-dragging through fistula in treating simple low and high anorectal fistula can shorten the course of the disease, save the hospitalization expenses, improve the life quality of the patients, and protect the anal sphincter function.
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OBJECTIVE: To study the effects of Wenshen Jianpi Recipe (WSJPR, a traditional Chinese medicine for warming kidney and invigorating spleen) on chronic wound healing and the mechanism. METHODS: Ninety-six SD rats were randomly divided into 4 groups, with 24 rats in each group, and back wound was made in the rats. For rats in 3 of the 4 groups, hydrocortisone injection was administered to induce chronic wound. Rats in 2 of the 3 groups were treated with WSJPR and Xinpukang Granules (XPKG) respectively, and the rats in the other group were untreated. The rats in the fourth group were taken as control. The wound healing time and the width of new epidermis were observed, and the histomorphological changes and cell cycle of the granulation tissue, and the protein expressions of epidermal growth factor (EGF), transforming growth factor-beta(1) (TGF-beta(1)) and fibronectin (FN) in the granulation tissue were tested with immunohistochemical technique and flow cytometry. RESULTS: The wound healing time of the WSJPR-treated and XPKG-treated groups was (17.0+/-1.9) and (18.8+/-1.9) d respectively, much shorter than that of the untreated and control groups (P<0.05). On the 14th experiment day, the width of new epidermis of the WSJPR-treated and XPKG-treated groups was (3.73+/-0.19) and (3.21+/-0.15) mm respectively, much wider than that of the untreated and control groups (P<0.05). The numbers of angiogenesis, fibroblasts and cells in the S phase in WSJPR-treated and XPKG-treated groups were much higher than those in the untreated and control groups (P<0.05). Compared with the untreated and control groups, the protein expressions of EGF, TGF-beta(1) and FN in WSJPR-treated and XPKG-treated groups were higher (P<0.05). CONCLUSION: WSJPR can enhance the wound healing. It was likely through accelerating the cell proliferation and up-regulating the expressions of EGF, TGF-beta(1) and FN.
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OBJECTIVES: To assess the efficacy of Fuhuang Tablets in treating internal hemorrhoid hemorrhage and discussing the design and quality control of clinical trials of traditional Chinese medicine. METHODS: According to two-center, randomized, blinded and controlled study, 144 patients with internal hemorrhoids were divided into 2 groups. Seventy-two patients were treated with Fuhuang Tablets (4 tablets t.i.d. per os) and the other 72 patients were treated with Zhining Tablets (4 tablets t.i.d. per os). Symptoms and signs of the patients were recorded and evaluated at the third and seventh day of treatment respectively. RESULTS: At the third day of treatment, the overall response rates of Fuhuang Tablets-treated group and Zhining Tablets-treated group were 58.57% and 27.78% respectively, with statistic difference between the two groups (P<0.05). At the seventh day of treatment, the overall response rates of Fuhuang Tablets-treated group and Zhining Tablets-treated group were 91.43% and 81.94% respectively, with no statistic difference between the two groups. The laboratory test results and life signs of the 144 patients were normal before and after the treatment. CONCLUSION: Fuhuang Tablets are effective and safe in treating internal hemorrhoid hemorrhage.