Herbal Textural Research on Treatment of Headache Based on Syndrome Differentiation / 中国实验方剂学杂志

ObjectiveTo summarize the thinking of treatment of headache based on syndrome differentiation by reviewing the literature of materia medica in the past dynasties， so as to guide the clinical practice. MethodAll the literature of materia medica in the Chinese Medical Dictionary， involving 76 works from Han to Qing Dynasties， were searched， and the information of the herbs for treating headache was extracted. According to Chinese Materia Medica （11th Edition） and Pharmacopoeia of the People's Republic of China （2020 Edition）， the nature， taste， and meridian tropism of the selected herbs were statistically analyzed， and the syndrome elements of headache were classified and counted. In addition， the contents of syndrome differentiation and treatment of headache by different herbs were extracted. ResultFrom the 76 monographs of materia medica in the past dynasties， 114 herbs for treating headache were selected. The herbs mainly had cold or warm nature， pungent or bitter taste， and tropism to the lung and live meridians. The syndrome elements of headache treated by the herbs mainly included wind attack， fire disturbance， turbid obstruction， stagnation， cold coagulation， and healthy Qi deficiency. ConclusionHeadache is mainly treated with the herbs with the effects of dispelling pathogenic wind， clearing heat and purging fire， eliminating phlegm and resolving dampness， regulating Qi movement and activating blood， warming Yang and dispelling cold， and tonifying deficiency and reinforcing healthy Qi， and the herbs are often used in combinations. Headache is treated following the principles of dispelling wind and pathogen， regulating Qi and blood， and tonifying deficiency and purging excess， which is in line with the laws of obstruction and nutrient deficiency causing pain.

Research and development of intelligent medical equipment and internationalization of acupuncture and moxibustion: thoughts from researchers of acupuncture robot / 中国针灸

Under the background of artificial intelligence, the internationalization of acupuncture and moxibustion has braced an important opportunity. Intelligent medical equipment for acupuncture and moxibustion has entered from the laboratory into the clinic. However, the current research focuses on optimizing acupuncture treatment technology rather than innovating acupuncture theory. Internationally, the westernization of traditional acupuncture and the dilution of its characteristics are worrying. It is urgent to promote the China-led international standards of acupuncture and moxibustion and the patent protection of traditional acupuncture and moxibustion. Intelligent medical equipment will play the role of media, and promote the internationalization of traditional acupuncture and moxibustion with standardized and highly-integrated intelligent medical equipment for acupuncture and moxibustion, and integrate modern scientific and technological achievements. It is a feasible way for the internationalization of acupuncture and moxibustion.

Novedades del glaucoma en tiempos de COVID-19 / News about glaucoma in the time of COVID-19

El impacto de la COVID-19 en la atención médica dominó las noticias en 2020, incluida la atención del glaucoma. Sin embargo, el reciente cambio de paradigma en la terapia de esta patología hacia una intervención más temprana, un mejor manejo del cumplimiento del paciente y un nuevo enfoque en abordar la patología real, continuó avanzando en este periodo con la aprobación de nuevos medicamentos, productos biológicos y dispositivos, que significaron avances en la atención médica. En este artículo, pretendemos reflexionar sobre los logros obtenidos en el año 2020 en el tratamiento del glaucoma, así como brindar una descripción general de los hallazgos más notables. Se realizó una búsqueda sistemática de la literatura científica de mayor impacto. Se limitó la búsqueda por tipo de diseño (revisiones, series de casos, estudios descriptivos, analíticos y experimentales, metanálisis). No se tuvo en cuenta el idioma de la publicación(AU)

The impact of COVID-19 on medical care was ever-present in the news during the year 2020, and glaucoma care was not an exception. However, the recent paradigm switch in the treatment of this condition towards earlier intervention, better management of patient compliance, and a new approach in addressing the actual disorder, continued to gain ground in this period with the approval of new drugs, biological products and devices leading to the advancement of medical care. The purpose of the study was to reflect on the progress achieved in the treatment of glaucoma in the year 2020, and provide a general description of the most notable findings. A systematic search was conducted in the highest-impact scientific literature. The search was limited to reviews, case series, descriptive, analytical and experimental studies, and meta-analyses. The language of publication was not taken into account(AU)

Analysis of clinical prognosis and influencing factors of optimal medical therapy for patients with coronary heart disease after percutaneous coronary intervention / 中国综合临床

Objective:To study the clinical prognosis and related factors affecting optimal medical therapy (OMT) compliance of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).Methods:A prospective study was conducted to select 3 818 patients who were diagnosed with CAD and successfully underwent PCI in TEDA International Cardiovascular Hospital from October 2016 to September 2017. The clinical information and application of OMT during hospitalization and 1 year later were collected for research.The patients were divided into OMT group and non OMT group according to whether they adhered to OMT during follow-up one year after discharge. After comparing the imbalance baseline data of hypertension,diabetes and hyperlipidemia with propensity score,demographic characteristics, coronary revascularization history, CAD, laboratory related laboratory examinations,and the use of OMT drugs were compared between the two groups. Cox regression model was used to analyze the relationship between long-term OMT and clinical prognosis in patients with CAD.Multivariate binary logistic regression was used to analyze the related factors affecting long-term OMT compliance.Results:A total of 3 818 cases of CAD patients were matched by propensity score and 2 596 patients were included in the study. There were 1 609 males and 987 females. The age was (62.51±9.56) years old.One year later,1298 patients (50%) insisted on OMT,including dual antiplatelet therapy(DAPT), statins, β-blockers and ACEI/ARB were 97.0% (2 517/2 596),94.5%(2 454/2 596),69.6% (1 806/2 596) and 64.2% (1 666/2 596), especially angiotensin converting enzyme inhibitors / angiotensin receptor blockers and β Receptor blockers decreased the most.Cox regression analysis showed that after adjusting for other factors, compared with non-adherence to OMT group,OMT after PCI was associated with better prognosis ( HR=0.416,95% CI 0.270-0.641, P<0.001). The prognosis of CAD patients with history of old myocardial infarction ( HR=1.804,95% CI 1.070-3.041, P=0.027),cardiac insufficiency ( HR=2.074,95% CI 1.161-3.702, P=0.014),multivessel coronary disease ( HR=2.211,95% CI 1.228-3.983, P=0.008) and BMI>24 ( HR=1.570,95% CI 1.037-2.377, P=0.033) were related to worse clinical outcomes. Multi-factor binary Logistic regression showed that OMT at hospitalization was a strong influencing factor of long-term adherence to OMT ( OR=41.278,95% CI 29.961-56.871, P<0.001). Patients with higher education,employee medical insurance and with history of PCI tend to persist in OMT. Conclusion:The medication compliance of patients with long-term OMT after PCI is still poor,while the high compliance of OMT is related to the lower incidence of adverse cardiovascular events,including death, nonfatal myocardial infarction and stroke. If there is no obvious contraindication,all patients after PCI should adhere to OMT.

Comparison of safety and efficacy of Ormeloxifene and Norethisterone acetate in the treatment of heavy menstrual bleeding

Background: Menorrhagia (menstrual blood loss more than 80% per cycle) affects 10-33% of women at some stage of their lives. Medical management is the first line of therapy for menorrhagia (heavy menstrual bleeding: HMB). Progestins have been found to be very effective in the management of heavy menstrual bleeding especially during acute episodes, norethisterone acetate being widely used for the same. Ormeloxifene is a new drug with promising results in managing HMB. The study was undertaken to compare the efficacy, safety and acceptability of Ormeloxifene /Norethisterone acetate in the medical management of heavy menstrual bleeding.Methods: This was a retrospective study conducted from January 2016 till December 2018 in which 98 women of reproductive age group presented with abnormal uterine bleeding without any organic, systematic and iatrogenic causes. The patients were divided into 2 groups. Those wanting contraception along with control of HMB were assigned to Group O and given Ormeloxifene and others were given norethisterone (Group N). The primary outcomes measured were menstrual blood loss assessed subjectively by patients and ultrasonography for endometrial thickness. The secondary outcomes measured were acceptability and side effects of Ormeloxifene and norethisterone.Results: There is a significant reduction in menstrual blood loss as evidenced by the history of patients recorded on follow up and there was a significant reduction in the endometrial thickness as evidenced on follow up scan at the end of 3-4 months. no major side effects were observed with both the drugs.Conclusions: Ormeloxifene in comparison to norethisterone acetate with its effectiveness, significant results, convenient dosages schedule and no major side effects is an effective and safe alternative medical management of HMB.

New Therapeutical Procedures of Peyronie’s Disease: Transfer Capacitive Resistive Energy in Association with Hydroelectrophoresis with Verapamil

Introduction: Efficacy evaluation of a new treatment, improving the symptoms of Peyronie’s disease (PD) inpatients with a curvature deformity < 30° and with an onset of symptoms of at least 6 months before the treatment.We investigated the effects of Transfer Capacitive Resistive Energy (TCARE) therapy accompanied byhydroelectrophoresis (HEP), a new electromotive system, for the transcutaneous delivery of Verapamil in menwith PD. Materials and Methods: Sixty-one patients affected by PD were enrolled. They were randomly dividedinto two groups: Group 1 (n. 30 patients, median age 56, range 49-62 yrs) was assigned to receive only TCARE;Group 2 (n. 31 patients; median age 58, range 51-60 yrs) received both TCARE and HEP. Every patientunderwent 16 treatment sessions, 2 sessions a week for each group. TCARE was performed with resistive energyand each treatment lasted 15 minutes. In Group 2 TCARE was also followed by HEP (with Hydro4and apparatus,Swiss4Med SA, Morbio Inferiore, Switzerland). HEP delivered 10 mg/4ml of Verapamil per session (2 ampoulesof Verapamil 5mg/2ml each; Isoptin, BGP products, Rome, Italy) for a 20-minute lasting. The endpoints were: apain increase in erection, the International Index of Erectile Function questionnaire (IIEF-15) scale score, andpenile curvature (in degrees). They were evaluated at the beginning of the study, at the end and three months afterthe discontinuation of the treatment. The pain was measured by using the Numeric Rating Scale (NRS) for pain1-10 and the erectile function by IIEF15. The penile curvature was measured instead by using photography, apersonal paper protractor after injection of PGE1 10 mcg. Some side effects during or immediately after thetreatment were recorded. Statistical analysis was performed using ANOVA for repeated measurements, correctedwith Bonferroni. The side effects were compared between the two groups using the Chi-square Test (test χ2).Results: The pain, the erectile function, and the penile curvature were all significantly improved with bothtreatments (p<0.001). In Group 2 (TCARE + HEP) the improvement was greater than Group 1 (p<0.001 for IIEFand curvature; p <0.05 for pain). The amelioration was maintained until three months after the end of treatment.No relevant side effects were observed or indicated by the patients. Conclusions: TCARE followed by Verapamiladministration by HEP is an effective and safe treatment for PD.

Comparison of medical therapy with renal denervation in patients with resistant hypertension

Introduction: Catheter-based renal denervation selectively reduces renal sympathetic efferent activity and is accompanied by an increase in renal blood flow and reduction in plasma renin activity. Thus, ablation of afferent and efferent renal nerves in patients with treatment-resistant hypertension probably leads to reductions in blood pressure. Material and methods: The present study conducted a non-randomized case-control study and enrolled 15 patients who underwent renal denervation therapy for resistant hypertension as cases and 16 patients who were on medical management for resistant hypertension served as controls. Results: It was found that catheter based renal denervation is safe, significantly reduces blood pressure at 1 month, 3 months and 6 months of follow-up without any major adverse events. It was observed that a significant BP reduction when compared to patients only on medical therapy. The mean number of drugs decreased significantly in the denervation group in follow-up. Conclusions: Though the present study showed a significant BP reduction in patients with renal denervation, a significant effect on BP was not observed in a large randomized trial simplicity HTN-3 and major criticism was on the trials design and neuroscience failings. Even today the clinical dilemma is still continuing and further evaluation in rigorously designed clinical trials are necessary to validate alternative methods of renal denervation or to confirm previously reported benefits of renal denervation. The current study anticipate that future trials will also address the effectiveness of renal denervation in disease states other than hypertension.

Medical therapy using omeprazole in 12 hydrocephalic dogs: clinical, diagnostic, and therapeutic findings / Terapia médica utilizando omeprazol em 12 cães hidrocefálicos: achados clínicos, diagnósticos e terapêuticos

According to experimental studies with healthy dogs, omeprazole might decrease the CSF production by about 26%; therefore, book texts have been suggested the usage of omeprazole in medical protocols for hydrocephalus treatment. However, to the best knowledge of the authors, the usage and medical response of the omeprazole with substantial group of illness dogs, such as hydrocephalic animals, was lacking. This report describes clinical, diagnostic, and therapeutic findings in 12 dogs with hydrocephalus in which omeprazole were used for medical treatment. The diagnosis of hydrocephalus was accomplished by transcranial sonography (TCS) and/or computed tomography. The ventricular measurement was assessed periodically by TCS during medical treatment. Six dogs were diagnosed with non-obstrutive hydrocephalus and in the other 6 cases hydrocephalus occurred with other concomitant anomalous encephalic disease often related with obstructive hysdrocephalus, such as quadrigeminal cist, arachnoid cyst, chiary-like malformation, and syringomyelia. All of them had medical improvement after the use of omeprazole and the most of the cases had ventricular size reduction. In 10 dogs, the omeprazole was used as single drug, and in 2 dogs medical treatment with steroids and/or diuretics was previously being performed, and omeprazole was added because conventional treatment was resulting in mild to unsatisfactory medical control of the neurological status. The results of this paper shown that omeprazole may be used to ameliorate the neurological status in symptomatic hydrocephalic dogs. This work may represent the first description about the use of omeprazole in order to treat a substantial group of affected dogs with suspected increased intracranial pressure by hydrocephalus, probably due to limitation of CSF production.(AU)

O omeprazol diminui a produção do fluido cerebrospinal (FCE) por cerca de 26% de acordo com estudos experimentais em cães saudáveis. Segundo o conhecimento dos autores, embora utilizado na prática clínica e recomendado em livros textos, não há até o momento estudos clínicos em um grupo substancial de animais avaliando a resposta terapêutica ao uso do omeprazol em pacientes enfermos, tais como cães hidrocefálicos sintomáticos. Este trabalho descreve os achados clínicos, diagnósticos e terapêuticos em 12 cães com hidrocefalia que foram submetidos ao tratamento com omeprazol para o manejo médico de hidrocefalia. O diagnóstico de hidrocefalia e doenças neurológicas concomitantes foi realizado por ultrassonografia transcraniana (USTC) e/ou tomografia computadorizada. A mensuração do tamanho ventricular foi realizada pela USTC durante o tratamento médico. Seis cães foram diagnosticados com hidrocefalia não obstrutiva e os outros 6 casos apresentaram hidrofalia concomitante com outras afecções encefálicas anômalas comumente associada à hidrocefalia obstrutiva, tal como cisto quadrigêmio, cisto aracnóide, síndrome de chiari-like e seringomegalia. Em 10 cães o omeprazol foi utilizado como droga única e em 2 cães a terapia inicial foi a convencional utilizando esteroides e diuréticos, e o omeprazol foi adicionado, pois a resposta clínica a terapia convencional foi insatisfatória. Todos os animais obtiveram melhora dos parâmetros neurológicos e a maioria teve uma redução do tamanho ventricular após o uso do omeprazol. Os resultados deste estudo demonstram que o omeprazol pode ser utilizado para melhorar o estado neurológico em cães com hidrocefalia. Este estudo representa a primeira descrição clínica usando o omeprazol para tratar uma série de cães com suspeita de aumento da pressão intracraniana devido à hidrocefalia, provavelmente pela capacidade do fármaco em limitar a produção do FCE.(AU)

Comparison of the curative effect between delayed PCI and medical therapy on ST-segment elevation acute myocardial infarction / 天津医药

Objective To investigate and compare the curative effect between delayed percutaneous coronary intervention (PCI) for patients with acute myocardial infarction presenting 12-24 hours from symptom onset and medical therapy on acute myocardial infarction patients presenting with ST-segment elevation (STEMI). Methods Using a prospective,open,parallel,controlled research approach,186 patients with STEMI were divided into delayed PCI group(n=89),which received PCI within 12-24 hours after STEMI and medical therapy group(n=97),which received medical therapy after STEMI. All patients were followed up 1-6 months with average follow-up (5.6 ± 1.4) months. Data of hospitalization period, the cardiac structures detected by echocardiography such as left atrial diameter (LAD), left ventricular diastolic diameter(LVDd),left ventricular ejection fraction LVEF,left ventricular fractional shortening(LVFS),composite end point events and major adverse cardiac events(MACE)were compared between the two groups.Results Compared with medical therapy group, the hospitalization cycle was significantly shorter in delayed PCI group. Data of the LAD and LVDd were significantly decreased,but LVEF and LVFS were increased in delayed PCI group compared with those of medical therapy group at 30 d and 6-month follow-up. The incidence of MACE and composite end point events were significantly less in delayed PCI group than those of medical therapy group (P<0.05). Conclusion Delayed PCI treatment can decrease the time of hospital stay and decrease the incidence rates of MACE and composite end point events,and improve left ventricular function and prognosis of patients.

Effect of percutaneous coronary intervention and medical therapy on quality of life and cognitive function in patients with coronary heart disease / 中南大学学报(医学版)

Objective:To explore the effect and difference of percutaneous coronary intervention (PCI) and medical therapy on quality of life and cognitive function in patients with coronary heart disease (CHD),and to investigate the relationship between quality of life and cognitive function.Methods:A total of 320 patients with CHD,who underwent coronary angiography and PCI (PCI group,n=160),or underwent coronary angiography and medical therapy (drug therapy group,n=160),were selected.The quality of life was assessed by using the Health Survey Form SF-36 (SF-36) and the Seattle Angina Questionnaire (SAQ),and the cognitive function was assessed by using the Mini-Mental State Examination (MMSE).General data of patients were collected on the day of coronary angiography.Telephone follow-up was conducted in 1 month after treatment,and the outpatient review was carried out in 3 and 6 months after treatment.Results:A total of 309 valid questionnaires were collected.The scores of quality of life in the PCI group and the drug therapy group after treatment were both increased compared with those before treatment (both P＜0.05).The SF-36 scores of four dimensions (role physical,bodily pain,vitality and mental health) in the PCI group were all significantly greater than those in the drug therapy group (all P＜0.05).The SAQscores of two dimensions (angina stability and angina frequency) were both higher in the PCI group than those in the drug therapy group in 6 months of post-operation (all P＜0.05).There was no significant difference in cognitive function before and after the treatment in the 2 groups (P＞0.05).There was no significant difference in cognitive function between the PCI group and the drug therapy group (P＞0.05).In the PCI group,physical function,role physical,bodily pain,and role emotional were positively correlated with cognitive function (r=0.207,0.182,0.184,0.176 respectively,all P＜0.05).In the drug therapy group,there was no correlation between quality of life and cognitive function.Conclusion:The quality of life for the patients is improved in the PCI group and the drug therapy group,but the improvement degree in the PCI group is more obvious.Both PCI and drug therapy do not result in the decrease of cognitive function,and there is no difference between the 2 groups.There is positive correlation between quality of life and cognitive function in the PCI group,there is no correlation between quality of life and cognitive function in the drug therapy group.

Impact of Cerebral Blood Perfusion and Cognitive Function of Carotid Artery Stenting Combined with Medical Therapy for Patients with Severe Internal Carotid Stenosis / 中山大学学报(医学科学版)

[objective]To study effect of cerebral blood perfusion and cognitive function of carotid artery stenting com-bined with medical therapy for patients with severe internal carotid stenosis.[Methods]124 patients with severe internal ca-rotid stenosis from June 2014 to June 2016 were divided into observed group and the treatment group,The treatment group given pure medical therapy,observation group given carotid artery stenting combined with medical therapy.One year follow-upr,cerebral blood flow perfusion,cognitive function,adverse events were compared between two groups.[Result]The ob-servation group rTTP,rMTT,rCBV,rCBF were significantly lower than treatment group(P<0.05,P<0.01);MMSE,MoCA score were significantly higher than treatment group(P<0.05);Vascular Occlusion,vascular restenosis,cerebral ischemic stroke,transient cerebral ischemia were significantly lower than treatment group(1.61% vs 11.29%,4.84% vs 19.35%, 1.61% vs 14.52%,4.84% vs 17.74,P<0.05).[Conclusion]Carotid artery stenting combined with medical therapy help to improve cerebral blood flow perfusion in patients with severe internal carotid stenosi,improve cognitive function,and pre-vent adverse events.

Assessment of the cardiovascular safety of initiating alogliptin therapy in type 2 diabetic patients after acute coronary syndrome: A Landmark Analysis of the EXAMINE Trial / 中华内分泌代谢杂志

Antihyperglycemic therapies may increase the risk of cardiovascular events. There is a paucity of data evaluating the cardiovascular safety of antihyperglycemic therapies in the high-risk period following an acute coronary syndrome ( ACS ) . This article is the Chinese translation of "Early and chronic dipeptidyl-peptidase-Ⅳinhibition and cardiovascular events in patients with Type 2 diabetes mellitus after an acute coronary syndrome: a Landmark analysis of the EXAMINE" published on Journal of the American Heart Association in May 2018 [ Sharma A, Cannon CP, White WB, et al. J Am Heart Assoc, 2018,7(11). Pii:e007649] with open access. The EXAMINE trial randomized 5380 patients who were 15 to 90 days after ACS to the DPP-Ⅳinhibitor alogliptin versus placebo;mean follow-up was 18 months. The landmark analysis were used to assess the burden of cardiovascular events from randomization to 6 months ( early period ) and from 6 months to the end of follow-up ( late period ) and the risk of cardiovascular events associated with early ( up to 6 months) and chronic ( 6 months to end of follow-up) DPP-Ⅳinhibition with alogliptin. Patients with early versus late events had similar baseline demographic profiles. Overall, 42.1％of the composite of cardiovascular death/myocardial infarction/stroke and 47. 5％ of hospitalization for heart failure occurred in the early period. Early DPP-Ⅳ inhibition with alogliptin did not increase the risk of early cardiovascular death/myocardial infarction/stroke (HR 0.96, 95％CI 0.76-1.21) or hospitalization for heart failure ( HR 1.23, 95％CI 0.84-1.82) . Similarly, chronic DPP-Ⅳinhibition with alogliptin did not increase the risk of late cardiovascular death/myocardial infarction/stroke (HR 1.03, 95％CI 0.89-1.26) or hospitalization for heart failure (hazard ratio 1.02, 95％ CI, 0.85-1.22). Early after an ACS, patients with type 2 diabetes mellitus experience a significant burden of heart failure events and recurrent ACS. DPP-Ⅳinhibition with alogliptin appears to be safe even in the high-risk period following an ACS.

Five-Year Outcomes of Successful Percutaneous Coronary Intervention with Drug-Eluting Stents versus Medical Therapy for Chronic Total Occlusions

PURPOSE: Many recent studies have reported that successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) for chronic total occlusion (CTO) has more beneficial effects than failed CTO-PCI; however, there are only limited data available from comparisons of successful CTO-PCI with medical therapy (MT) in the Korean population. MATERIALS AND METHODS: A total of 840 consecutive CTO patients who underwent diagnostic coronary angiography, receiving either PCI with DESs or MT, were enrolled. Patients were divided into two groups according to the treatment assigned. To adjust for potential confounders, propensity score matching (PSM) analysis was performed using logistic regression. Individual major clinical outcomes and major adverse cardiac events, a composite of total death, myocardial infarction (MI), stroke, and revascularization, were compared between the two groups up to 5 years. RESULTS: After PSM, two propensity-matched groups (265 pairs, n=530) were generated, and the baseline characteristics were balanced. Although the PCI group showed a higher incidence of target lesion and vessel revascularization on CTO, the incidence of MI tended to be lower [hazard ratio (HR): 0.339, 95% confidence interval (CI): 0.110 to 1.043, p=0.059] and the composite of total death or MI was lower (HR: 0.454, 95% CI: 0.224 to 0.919, p=0.028), compared with the MT group up to 5 years. CONCLUSION: In this study, successful CTO PCI with DESs was associated with a higher risk of repeat PCI for the target vessel, but showed a reduced incidence of death or MI.

The Efficacy of Sound Therapy and Conventional Medical Treatment in the Treatment of Chronic Tinnitus： A Meta-analysis / 听力学及言语疾病杂志

Objective To compare the efficacy of sound therapy and conventional medical treatment in the treatment of chronic tinnitus.Methods CNKI,Wanfang database,Weipu database (VIP),Chinese biomedical literature database (CBM),Pubmed,Embase,OVID,SciVerse ScienceDirect and Cochrane library were used.The data were retrieved up to May 2017,and the relevant literature was screened according to the inclusion and emission standards.The quality of the literatures were analyzed and the data was extracted.Meta analysis was carried out by using Revman 5.2 software with total effective rate,tinnitus handicap inventory(THI) value and visual analogue scale(VAS) value.Results A total of 16 articles (1 594 patients) were included in the literature,including 14 articles in Chinese and 2 articles in English.The total effective rate in the sound therapy group were 86.42 ％ (by patients) and 80.50％ (by ears),while in conventional medical treatment group were 60.62％ (by patients),and 48.10％ (by ear),respectively[P＜0.01 (by patients),P＜0.01 (by ear)].The changes of THI value were analyzed before and after treatment,the difference was statistically significant(P＜0.01).The changes of VAS value were analyzed before and after treatment,the difference was statistically significant (P＜0.05).Conclusion Compared with conventional medical treatment,sound therapy can significantly improve the clinical efficacy of tinnitus treatment and reduce the symptoms in tinnitus patients.

The Effectiveness of Selective Laser Trabeculoplasty in Patients with Medically Uncontrolled Open-angle Glaucoma

PURPOSE: To determine the effect of intraocular pressure (IOP) reduction of selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and the factors associated with the treatment result. METHODS: Forty-seven eyes of 47 OAG patients were enrolled for 180° SLT or 360° SLT, all under maximal tolerated medical therapy and with IOP above their target pressure. All patients were followed-up for at least 1 year after the procedure. Treatment success was defined as IOP reduction ≥20% from baseline at 12 months after SLT treatment without additional anti-glaucomatous intervention. RESULTS: The treatment success rate was 65.96%. Baseline IOP was 23.84 ± 4.52 mmHg in the success group and 21.44 ± 2.97 mmHg in the failure group (p = 0.035). Significant mean IOP reduction was observed at 6, 9, and 12 month follow-ups (p = 0.001 at 6 months; 0.041 at 9 months, and <0.001 at 12 months). The success rate did not vary significantly by sex (p = 0.362), age (p = 0.081), history of cataract surgery (p = 0.470), number of medications (p = 0.857), duration of medication (p = 0.613), or angular degree of SLT treatment (180° vs. 360°) (p = 0.137). There was a positive correlation between mean baseline IOP and mean reduction of IOP from baseline in the success group (p < 0.001, r = 0.861), while there was no such correlation in the failure group (p = 0.272, r = −2.921). CONCLUSIONS: SLT was an effective treatment for IOP reduction until 12 months in medically uncontrolled OAG patients. A greater amount of IOP reduction is expected in patients with higher baseline IOP in the success group.

Current Medical Therapy for Uterine Leiomyomas / 고신대학교의과대학학술지

Uterine leiomyomas are benign tumors arising from the myometrium and largely prevalent in the woman's reproductive years. The majority of women with leiomyomas either remain asymptomatic or develop symptoms gradually over time. When patients are symptomatic, the nature of their complaints is often attributable to the number, size, and/or location of their fibroids. Depending on a patient's symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy).

Current management of myocardial infarction treated at the state second central hospital / Монголын Анагаах Ухаан

AimThe aim was to study retrospectively the possible changes in practice patterns in the managementof patients with acute myocardial infarction who were admitted to the State Second Central Hospitalduring the last 5 years.Material and MethodThis study conducted at the State Second Central Hospital in September 2014.Patients with acute myocardial infarction were divided into 2 groups: main and control. Main groupincluded 95 patients with myocardial infarction who were treated from 2010 to July 2014. Controlgroup included 102 patients with myocardial infarction who were treated from 2005 to 2009.From 2005 to 2012 patients fulfilled the diagnostic criteria of myocardial infarction based on WHOcriteria. From 2013 to 2014 patients fulfilled the diagnostic criteria of myocardial infarction based onnational guideline’s criteria. Differences in proportions in the groups were tested with the chi squaretest. P value of <0.05 was considered significant.ResultsA total 197 patients (mean age 71.2±6.1, 62% man, and 38% women) with acute myocardial infarctionwere enrolled. More than half had a history of arterial hypertension. Atypical forms of myocardialinfarction increased from 25.8% in 2005-2009 to 40.4% in 2010-2014. ST elevation myocardialinfarction and non ST elevation myocardial infarction were detected in 61% and 39% of patientstreated in 2010-2014. Diagnostic use of troponin was increased significantly in last 5 year (44.2% vs.88.6%, p<0.05).The study revealed only 17.2% of patients with acute myocardial infarction met the national guidelinesgoal of pre-hospital time <12 hours. Eighty four (88.3%) patients of the main group received medicaltherapy and 11(11.7%) treated with percutaneous coronary intervention. Aspirin was prescribed in80.7% of main group, heparin in 97.9%, ACE inhibitors in 47.9%, Beta blocker in 14.9% within 24hours of acute myocardial infarction.ConclusionsCompared with control group use of troponin and invasive treatment strategy has increased since2010 in the management of patients with acute myocardial infarction. Delay of pre-hospital timeremains an actual problem in the management of acute myocardial infarction.

Attitude of Residents of a Rural Community in South-South, Nigeria towards Alternative Medical Therapy.

Background: Up to 80 percent of Africans are reported to use some form of alternative medical therapy (AMT) to meet their health needs. There are gaps in knowledge relating to attitude towards AMT in south- south Nigeria. An understanding of beliefs and the prevailing factors that influence the patronage of traditional medicine in this environment may help inform policy interventions. Objectives: This study aimed to assess the awareness of and attitude towards AMT amongst the inhabitants of a rural community in south-south Nigeria. Materials and Methods: This was a cross sectional survey involving 300 respondents selected by a two stage sampling technique, using a self-designed interviewer administered structured questionnaire. Results were presented as proportions with chi-squared test done to determine associations. Level of significance was set at 0.05. Results: Mean age of the 300 respondents was 35.7±11.7 with 237 persons (79.0%) earning less than $250 monthly and 168 (56.0%) having secondary education. Majority 297 (99%) were aware of AMT and 287 (95.7%) cited herbal concoctions as the most prevalent method. Few were aware of side effects of AMT 71 (23.7%). Majority 208 (69.3%) preferred AMT to orthodox treatment, and were willing to refer others to AMT practitioners. Of these 159 (76.4%) claimed AMT to be more effective and 140 (67.3%) more affordable. Age of respondents, educational status, occupation and average monthly income were all found to be associated with preference of AMT (p<0.5). Conclusion: Alternative medical therapy is favoured by majority of the respondents in spite of the risks. Public enlightenment campaigns, better regulation, and implementation of community health insurance for affordable health care are advocated.

Ozone (O3): an excellent adjunctive tool in medical and surgical management of patient.

In the condition like increasing susceptibility to allergic reaction & weaken response to antibiotics, along with constantly growing prices for medical treatment, new non-medicinal methods are to be appreciated. The history of medical ozone starts in the XX century. The pioneers to apply ozone in clinical practice were E. Payer, A. Fish and H. Wolf. Ozone as an antiseptic means had been known and used from the beginning of the XX century, however, extensive and systemic research in the field of ozone therapy started in Germany in mid 70s, when ozone-resistant polymer materials and convenient ozone generating equipment came into every day clinical practice. Ozone (O3) therapy due to its disinfection effect & its capacity to transport & release oxygen into tissues is gaining a justified recognizing in many countries of the world. O3 therapy can produce its immune modulators, anti-inflammatory, bactericidal, virucidal, fungicidal, analgesics & other effects. Considering this the purpose of this literature is to highlight the significance of Ozone as an excellent adjunctive tool in the management of various medical and surgical conditions.

A Case of Duodenal Intramural Hematoma Caused by Acute Alcoholic Pancreatitis / 대한췌담도학회지

Intramural duodenal hematoma (IDH) is a rare disease which defined a hematoma formation localized within the wall of the duodenum. The most common cause of IDH is due to blunt abdominal trauma while most of other cases of IDH are more related to the use of anticoagulants or coagulation disorders such as haemophilia and Von Willebrand disease. We report a very rare case of a large IDH caused by acute alcoholic pancreatitis without any kind of anticoagulation therapies nor coagulopathies. The patient was recovered by only medical treatment and observation without surgical intervention.