Study on evaluation criteria for the quality of Chinese patent medicine purchased centrally by the Guangdong alliance / 中国药房

Since the Guangdong alliance launched the centralized procurement of Chinese patent medicine， manufacturers have engaged in fierce price competition to obtain the qualification for selection. In order to ensure that manufacturers have lowered the price without decreasing quality， the evaluation criteria for the quality of Chinese patent medicine is constructed on the basis of the characteristics of traditional Chinese medicine. The evaluation criteria consist of the production process and therapeutic effect evaluation. The evaluation indicators involve raw materials， processing and clinical use covering the whole life cycle of Chinese patent medicine. The evaluation of production process includes 3 secondary indicators （the quality of traditional Chinese medicine， the quality of traditional Chinese medicine decoction pieces and the quality of Chinese patent medicines） and 13 tertiary indicators （standardized production， quality inspection， processing specifications， technical processes， safety risk control， etc.）， which fully reflect the quality control of key links in the production of Chinese patent medicine. The therapeutic effect evaluation includes 5 secondary indicators （theoretical origin of formulation， proactive research by production enterprises， evidence-based medical evidence， clinical use， and technological embodiment） and 18 tertiary indicators （theoretical sources， post-market effectiveness re- evaluation， clinical guidelines， expert consensus， etc.） to assess the quality and efficacy of Chinese patent medicine from multiple perspectives and levels. This study is a useful supplement to the scheme of centralized procurement of Guangdong alliance， which can not only provide data support for selecting “low-cost and high-quality” Chinese patent medicine， but also provide information reference for hospitals to make procurement decisions.

Effect of processing with vinegar on efficacy of Curcuma longa in treatment of dysmenorrhea in rats with syndrome of liver depression and Qi stagnation / 中国中药杂志

This study compared the effects of Curcuma longa before and after processing with vinegar on the rat model of dysmenorrhea with the syndrome of liver depression and Qi stagnation to reveal the mechanism of vinegar processing in improving the role of C. longa in soothing liver and relieving pain. The rat model of dysmenorrhea with the syndrome of liver depression and Qi stagnation was established according to the Preparation of the Animal Model of Dysmenorrhea(Draft) and the chronic unpredictable stress me-thod. The changes in the body weight, organ indexes, writhing latency, writhing score, and serum levels of six liver function indicators, sex hormones, pain factors, and blood rheological indicators were measured to evaluate the efficacy of C. longa processed with vinegar or not in treating dysmenorrhea in the rats with syndrome of liver depression and qi stagnation. Compared with the model group, the C. longa group(processed with vinegar or not) showed slow weight loss, increase in writhing latency, and decrease in writhing response(P<0.05). The inhibition rates on writhing in raw C. longa, vinegar-processed C. longa, and positive groups were 33.780%, 64.611%, and 62.466%, respectively. The significantly higher inhibition rate of the vinegar processing group indicated that vinegar-processed C. longa demonstrated more significant therapeutic effect. The vinegar-processed C. longa group showed lower levels of alanine aminotransferase(ALT), alkaline phosphatase(ALP), aspartate aminotransferase(AST), direct bilirubin(DBIL), and total bilirubin(TBIL) and higher level of albumin(ALB)(P<0.05), which indicated that vinegar processing enhanced the therapeutic effect of C. longa on liver injury. The serum levels of estradiol(E_2) and oxytocin(OT) were lower in the vinegar-processed C. longa group(P<0.05), indicating that the vinegar-processed C. longa could regulate the sex hormone levels, reduce the activity of uterine smooth muscle and contraction of uterus, and alleviate the symptoms of dysmenorrhea in rats. Moreover, the vinegar-processed C. longa group showed lower interleukin-6(IL-6) and arginine vasopressin(AVP) levels and higher beta-endorphin(β-EP) level(P<0.05), which indicated that vinegar-processed C. longa regulated the levels of pain factors to exert the pain-relieving effect. Drug intervention decreased the whole blood viscosity low-cut, medium-cut and high-cut values, plasma viscosity, whole blood reduction viscosity low-cut and high-cut values, erythrocyte cumulative pressure, and equation K value of erythrocyte sedimentation rate(P<0.05), and the vinegar-processed C. longa group outperformed other groups. This result indicated that vinegar processing enhanced the function of C. longa in improving the local blood rheology. C. longa processed with vinegar can enter the liver to relieve the da-mage to the heart, liver, kidney, and uterus, repair the liver function, and recover the sex hormone levels and immune function by regulating the levels of sex hormones and pain factors and improving the blood rheology. It activates the pain-relieving mechanism to relieve the pain, protect the liver, and fight inflammation, which is consistent with the theory that vinegar processing facilitates C. longa entering the liver to sooth liver and relieve pain.

Efficacy and safety of neoadjuvant chemotherapy combined with PD-1 antibody for esophageal squamous cell carcinoma in the real world / 中华肿瘤杂志

Objective: To evaluate the efficacy and safety of neoadjuvant chemotherapy combined with programmed death-1 (PD-1) antibody in operable, borderline or potentially resectable locally advanced esophageal squamous cell carcinoma(ESCC) in the real world. Methods: The study retrospectively analyzed 28 patients with operable or potentially resectable locally advanced ESCC patients treated with preoperative chemotherapy combined with PD-1 inhibitor in Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School from April 2020 to March 2021. According to the clinical TNM staging system of the 8th edition of the American Joint Committee on Cancer, there were 1, 15, 10, 1 and 1 case of stage Ⅱ, Ⅲ, ⅣA, ⅣB and unknown stage respectively. The treatment was two cycle of dual drug chemotherapy regimen including taxane plus platinum or fluorouracil combined with PD-1 antibody followed by tumor response assessment and surgery if the patient was eligible for resection. Results: Of the 28 patients, 1, 2, 3 and 4 cycles of chemotherapy combined with PD-1 antibody treatment completed in 1, 21, 5, and 1 patient, respectively. Objective response rate (ORR) was 71.4% (20/28), and disease control rate (DCR) was 100% (28/28). The incidence of adverse events exceeding grade 3 levels was 21.4% (6/28), including 3 neutropenia, 1 leukopenia, 1 thrombocytopenia and 1 immune hepatitis. There was no treatment-related death. Of the 23 patients underwent surgery, R0 resection rate was 87.0% (20/23), 13 patients had down staged to the T1-2N0M0 I stage, the pCR rate was 17.3% (4/23), and the pCR rate of primary tumor was 21.7% (5/23). Four patients received definitive chemoradiotherapy. One patient rejected surgery and other treatment after achieved PR response. Conclusion: Neoadjuvant chemotherapy combined PD-1 inhibitor is safe and has high efficacy in operable, borderline or potentially resectable locally advanced ESCC, and it is a promising regimen.

Evaluation of the therapeutic effect of deuterium depleted water on gastroenteritis induced by 131I radiation in thyroid cancer treatment / 中国辐射卫生

Objective To investigate the therapeutic effect of oral administration of deuterium depleted water on gastroenteritis induced by 131I radiation in thyroid cancer treatment. Methods Fifty patients with papillary thyroid cancer treated with 131I in the Department of Nuclear Medicine of Changshu No.2 People’s Hospital from May 2022 to February 2023 were divided into control group and experimental group (25 patients in each group). Data were continuously collected throughout the study duration. The control group was orally administrated omeprazole enteric-coated capsules and purified water at 660 mL tid for 5 days. The experimental group received the same basic treatment as the control group except that deuterium depleted water was used instead of purified water. The incidence and alleviation of 131I radiation-induced gastroenteritis were observed and compared between the two groups using the Fisher’s exact test and Kaplan-Meier analysis. Results The number of gastroenteritis cases from day 1 to day 5 after 131I administration was 2 (8%), 5 (20%), 2 (8%), 1 (4%), and 0 (0%), respectively, in the experimental group, and 2 (8%), 8 (32%), 4 (16%), 3 (12%), and 1 (4%), respectively, in the control group. The incidence of gastroenteritis was significantly different between the two groups (χ2=4.064, P=0.044). After 5 days of treatment, the overall response rate of patients in the experimental group was 96%, which was significantly higher than 76% in the control group (χ2=9.105, P=0.025). Conclusion Oral administration of deuterium depleted water is effective in the relief of clinical symptoms of 131I radiation-induced gastroenteritis in thyroid cancer treatment. The clinical application of deuterium depleted water should be further investigated.

Therapeutic Effect of Modified Baqia Baweitang on Diabetic Foot Due to Dampness-heat Toxicity / 中国实验方剂学杂志

ObjectiveTo observe the clinical effect of modified Baqia Baweitang on diabetic foot due to dampness-heat toxicity. MethodOne hundred and four patients were randomized into control and observation groups （52 cases）. The control group was treated with epalrestat combined with Compound Huangbai Liquid， and the observation group with modified Baqia Baweitang on the basis of the therapy in the control group. The resting pain， intermittent claudication， foot cold feeling， traditional Chinese medicine （TCM） symptoms， ulcer area， ulcer surface pH， ulcer depth， and percutaneous oxygen partial pressure were measured before and after treatment. The blood glucose and lipid levels ［fasting blood glucose （FPG）， 2 h postprandial blood glucose （2 h PG）， triglyceride （TG）， and total cholesterol （TC）］， hemorheological indexes （peak blood flow， blood flow， vascular diameter， and pulse index）， motor and sensory nerve conduction velocity， and inflammatory cytokines ［tumor necrosis factor-α （TNF-α）， interleukin （IL）-6， IL-13， and C-reactive protein （CRP）］ in the serum and skin lesions were determined. The clinical efficacy and safety were compared between the two groups. ResultThe total response rate in the observation group was 96.2% （50/52）， which was higher than that （80.8%， 42/52） in the control group （χ2=6.029， P<0.05）. The treatment in both groups decreased the resting pain， intermittent claudication， foot cold feeling， TCM symptom scores， ulcer area， ulcer surface pH， and ulcer depth （P<0.05） and increased the percutaneous oxygen partial pressure （P<0.05）. Furthermore， the treatment lowered the levels of FPG， 2 h PG， TG， TC， blood flow peak， TNF-α， IL-6， IL-18， and CRP （P<0.05） and increased the blood flow， vascular diameter， pulse index， and the motor and sensory nerve conduction velocity （P<0.05）. Moreover， the changes in the above indexes were more significant in the observation group than in the control group （P<0.05）.The incidence of adverse reactions was 21.2% （11/52） in the control group and 23.1% （12/52） in the observation group， with no statistical significance. ConclusionModified Baqia Baweitang can promote wound healing， improve the dorsal artery hemorheology of feet， accelerate nerve conduction， and reduce inflammation in the patients with diabetic foot due to dampness-heat toxicity.

The application of Xing's ureteroileal anastomosis technique in urinary diversion / 中华泌尿外科杂志

Objective:To evaluate the clinical value of Xing's ureteroileal anastomosis technique in radical cystectomy.Methods:The data of 38 patients who underwent radical cystectomy with Xing's ureteroileal anastomosis technique at Cancer Hospital, Chinese Academy of Medical Sciences and Beijing Chaoyang Hospital from July 2013 to June 2021 were retrospectively reviewed. There were 30 males and 8 females. The mean age was 61.6±15.1 years old. The mean body mass index (BMI) was 25.1±2.7 kg/m 2. The American Society of Anesthesiology (ASA) graded 25 cases as grade 1, 10 cases as grade 2 and 3 cases as grade 3. There were 35 cases with stage cT 2N 0M 0 and 3 cases with cT 3N 0M 0. All patients underwent radical cystectomy and ileal conduit, and the ureteroileal anastomosis was performed using the Xing's ureteroileal anastomosis technique. Afferent loop entry was divided equally into two lumens. After 1.5 cm-long lengthwise incisions, each ureter was directly and end-to-end anastomosed to the aforementioned lumens. Postoperative information was recorded, including ureteric stricture, ureteric reflux, hydronephrosis, anastomotic leakage, renal calculus, urinary tract infection, and pyelonephritis. Results:Ureteroileal anastomosis was performed successfully in 38 cases with 76 units. The median follow-up time was 35.6 (17.0, 46.3) months. Three patients developed unilateral anastomotic stenosis after operation. Five patients had unilateral ureteral reflux. Two patients had unilateral hydronephrosis. No anastomotic leakage, urinary tract infection, or pyelonephritis occurred after the operation. Renal calculus appeared in 3 cases, all on the left unit.Conclusions:Xing's ureteroileal anastomosis technique is a simple method with few postoperative and good functional outcomes.

Influential factors of the efficacy of tinnitus multivariate integrated sound therapy for the treatment of subjective tinnitus / 中国基层医药

Objective:To investigate the influential factors of the efficacy of tinnitus multivariate integrated sound therapy (T-MIST) in the treatment of subjective tinnitus.Methods:A total of 431 patients with subjective tinnitus who received treatment in The First Affiliated Hospital of Xiamen University from June 2019 to June 2020 were included in this study. A cross-sectional study method was used to conduct refined testing on tinnitus patients using the T-MIST matching platform. The severity of tinnitus patients was evaluated using the Tinnitus handicap inventory scale. SPSS software was used to analyze the factors affecting the effectiveness of the T-MIST for subjective tinnitus based on patients' basic characteristics.Results:Multivariate logistic regression analysis showed that compared with patients with short-term tinnitus, OR (95% CI) was 1.982 (1.033-3.804), P = 0.040, in patients with 3-12 months of disease duration, OR (95% CI) was 2.411 (1.322-4.396), P = 0.004 in patients with > 12 months of disease duration. With the increase in tinnitus handicap inventory score, the efficacy of T-MIST became better [ OR (95% CI) = 1.014 (1.004-1.024), P = 0.007]. The efficacy of T-MIST was better in the hearing compensation-effective patients [ OR (95% CI) = 0.133 (0.081-0.216), P < 0.001]. Conclusion:The course of the disease, tinnitus handicap inventory score, and effective hearing compensation are the influential factors of T-MIST. They can provide evidence for the treatment of subjective tinnitus.

The therapeutic effect of bone peptide combined with rifapentin and levofloxacin in the treatment of bone and joint damage caused by brucellosis / 中华地方病学杂志

Objective:To study the therapeutic effect of bone peptide combined with rifapentin and levofloxacin on bone and joint damage caused by brucellosis.Methods:A prospective study was conducted to select 64 patients with brucellosis bone and joint damage admitted to Shanxi Provincial People's Hospital from January 2017 to June 2021. They were randomly divided into a control group (32 cases) and an observation group (32 cases) using a random number table method. The control group was treated with rifapentin and levofloxacin, while the observation group was treated with bone peptide on the basis of the control group, with a treatment period of 8 weeks, and the peripheral venous blood sample was collected before and after treatment. The visual analogue scale (VAS), activity of daily living (ADL) score, serum C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)] levels were compared before and after treatment.Results:The total effective rates of treatment in the observation group and the control group were 90.62% (29/32) and 65.62% (21/32), respectively, with statistically significant differences between the groups (χ 2 = 5.85, P = 0.016). After treatment, the VAS score of the observation group was lower than that of the control group ( t = 8.29, P < 0.001), and the ADL score was higher than that of the control group ( t = 6.77, P < 0.001). Both groups had lower VAS scores after treatment than before treatment in the same group ( t = 21.72, 15.09, P < 0.001), and higher ADL scores than before treatment in the same group ( t = 22.49, 12.54, P < 0.001). After treatment, the levels of CRP, PCT, ESR, TNF-α, and IL-6 of the observation group were lower than those of the control group ( t = 8.11, 10.75, 4.64, 5.11, 4.55, P < 0.001); the levels of CRP, PCT, ESR, TNF-α, and IL-6 in the two group were lower than these before treatment in the same group ( t = 14.21, 21.47, 11.21, 15.07, 9.73, 15.50, 21.30, 7.52, 6.78, 4.93, P < 0.001). Conclusion:The bone peptide combinated with rifapentin and levofloxacin has a good therapeutic effect on bone and joint damage caused by brucellosis, which can significantly reduce pain and cellular inflammatory reactions in patients, and improve their quality of life.

Clinical Trial of Buyang Huanwutang in Treatment of Connective Tissue Disease-associated Pulmonary Fibrosis with Syndrome of Qi Deficiency and Blood Stasis / 中国实验方剂学杂志

ObjectiveTo evaluate the effect and safety of Buyang Huanwutang in treatment of connective tissue disease-associated pulmonary fibrosis in the patients with syndrome of Qi deficiency and blood stasis and explore the possible anti-fibrosis mechanism of Buyang Huanwutang. MethodSixty-six patients with connective tissue disease-associated pulmonary fibrosis with syndrome of Qi deficiency and blood stasis were randomized to receive either Buyang Huanwutang combined with routine therapy or routine therapy for 4 weeks. The primary outcome indicator was change in forced vital capacity （FVC） from the baseline， and the secondary outcome indicators included the changes in percentage of predicted forced vital capacity （FVC%pred）， percentage of forced expiratory volume in first second to predicted value （FEV1%pred）， King's Brief Interstitial Lung Disease （K-BILD） total score， 6 minute walking distance （6MWD）， hydroxyproline （HYP）， matrix metalloproteinase （MMP）， tissue inhibitor of metalloproteinase-1 （TIMP-1）， and transforming growth factor-β （TGF-β） from baseline. Patients in line with the inclusion criteria were included in the primary analysis， and sensitivity analysis was performed after multiple imputation of missing data. Safety set was adopted for safety analysis. ResultThe 66 patients （included in the sensitivity analysis） meeting the inclusion criteria included 34 in the observation group and 32 in the control group， and 60 patients finally received the whole trial intervention （included for primary analysis）. Compared with the baseline， the FVC increased in the observation group and decreased in the control group after intervention （P<0.01）， which was consistent between the sensitivity analysis and the primary analysis. The changes in FVC%pred， FEV1%pred， 6MWD， and K-BILD total score from baseline in the observation group were superior to those in the control group （P<0.01）， with consistent results between the sensitivity analysis and the primary analysis. TIMP-1 in the observation group decreased compared with baseline （P<0.05）， while TIMP-1 in the two groups showed no significant changes from the baseline The observation group outperformed the control group in the changes in HYP， MMP-9， and TGF-β from baseline （P<0.05）. The common adverse events were cough， diarrhea， nausea， rash， and upper gastrointestinal tract infection， the incidence of which showed no statistical difference between the two groups. ConclusionBuyang Huanwutang can improve lung function， motor function， and quality of life in patients with connective tissue disease-associated pulmonary fibrosis and has good safety. The mechanism may be related to the reduction of TGF-β， MMP-9， and TIMP-1 levels and maintaining of MMP-9/TIMP-1 balance.

Relationship of actual absorbed dose and volumetric change in patients with squamous cell carcinoma of thyroid treated by 125I radioactive seeds / 中华内分泌外科杂志

Objective:To investigate the relationship between dosimetric parameters and tumor volume change after 125I implantation for thyroid cancer and obtain better dosimetric parameters that predict the curative effect more accurately. Methods:A total of 22 consecutive patients with thyroid cancer (23 targets) who received 125I interstitial brachytherapy in Department of Oncology, Hebei General Hospital were retrospectively analyzed. All the patients received post-operative dose verification, and the D 90 (Minimum dose received by 90% target volume) was calculated. After a regular follow-up, the tumor volume reduction ratio after t months (R t) , actual absorbed dose (D 1m) , efficacy corrected absorbed dose (D 1e) , and sensitivity corrected absorbed dose (D 1s) of the first month were calculated according to the actual follow-up CT images. The statistical test was carried out by SPSS21.0. The Spearman linear analysis was applied to analyze the relationship between D 90, D 1m, D 1e, D 1s and R t, and the curve fitting was also completed. Results:The post-operative D 90, D 1m, D 1e, D 1s and R t were (129.73±14.22) Gy, (36.95±7.35) Gy, (43.45±11.32) Gy, (41.78±13.39) Gy, and (32.00±19.00) %, respectively. And the correlation coefficient were 0.692, 0.551, 0.728, and 0.858, respectively, which showed significant positive relevance between dosimetric parameters and tumor volume change ( P<0.01) , the curve fitting presented cubic function. Conclusion:The post-operative D 90, D 1m, D 1e, and D 1s can be predictors for curative effect, and D 1s is the best predictor.

Clinical Effect of Mahuang Xixin Fuzitang Combined with Acupuncture and Moxibustion in Treatment of Localized Scleroderma / 中国实验方剂学杂志

ObjectiveTo observe the clinical effect of Mahuang Xixin Fuzitang combined with acupuncture and moxibustion in the treatment of localized scleroderma. MethodA total of 95 patients with localized scleroderma treated in Wuhan No. 1 Hospital from September 2019 to October 2021 were assigned into a control group （47 patients） and an observation group （48 patients） by random number table method. The control group was treated with Centella triterpenes tablets and heparin sodium cream， and the observation group was additionally treated with Mahuang Xixin Fuzitang combined with acupuncture and moxibustion. Both groups were treated for 8 weeks， and the clinical effect was compared between groups. The traditional Chinese medicine（TCM） syndrome score （local skin sclerosis， loss of skin texture， darkening of skin pigment， scaly dry skin， etc.）， serum levels of soluble interleukin-2 receptor （sIL-2R） and tumor necrosis factor-alpha （TNF-α）， erythrocyte sedimentation rate （ESR）， and eosinophil count （EO） were compared between before and after treatment as well as between groups. Additionally， the adverse reactions were recorded. ResultThe observation group had higher total effective rate than the control group ［95.83% （46/48） vs. 82.98% （39/47）， χ2=4.166 4， P<0.05］. Before treatment， the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO showed no significant differences between the two groups. The 8 weeks of treatment improved the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO. Moreover， the observation group was superior to the control group in these indicators （P<0.05）. During the treatment， the observation group showed 1 case of abnormal liver function and 1 case of nausea and vomiting， and the control group had 1 case of nausea and vomiting， 1 case of abnormal renal function， and 1 case of abnormal liver function. The total adverse reactions of the observation group （4.17%） and the control group （6.38%） had no significant difference （χ2=0.233 9， P=0.062 86）. ConclusionMahuang Xixin Fuzitang combined with acupuncture and moxibustion is safe and effective in the treatment of localized scleroderma.

Clinical Effect of Mahuang Xixin Fuzitang Combined with Acupuncture and Moxibustion in Treatment of Localized Scleroderma / 中国实验方剂学杂志

ObjectiveTo observe the clinical effect of Mahuang Xixin Fuzitang combined with acupuncture and moxibustion in the treatment of localized scleroderma. MethodA total of 95 patients with localized scleroderma treated in Wuhan No. 1 Hospital from September 2019 to October 2021 were assigned into a control group （47 patients） and an observation group （48 patients） by random number table method. The control group was treated with Centella triterpenes tablets and heparin sodium cream， and the observation group was additionally treated with Mahuang Xixin Fuzitang combined with acupuncture and moxibustion. Both groups were treated for 8 weeks， and the clinical effect was compared between groups. The traditional Chinese medicine（TCM） syndrome score （local skin sclerosis， loss of skin texture， darkening of skin pigment， scaly dry skin， etc.）， serum levels of soluble interleukin-2 receptor （sIL-2R） and tumor necrosis factor-alpha （TNF-α）， erythrocyte sedimentation rate （ESR）， and eosinophil count （EO） were compared between before and after treatment as well as between groups. Additionally， the adverse reactions were recorded. ResultThe observation group had higher total effective rate than the control group ［95.83% （46/48） vs. 82.98% （39/47）， χ2=4.166 4， P<0.05］. Before treatment， the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO showed no significant differences between the two groups. The 8 weeks of treatment improved the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO. Moreover， the observation group was superior to the control group in these indicators （P<0.05）. During the treatment， the observation group showed 1 case of abnormal liver function and 1 case of nausea and vomiting， and the control group had 1 case of nausea and vomiting， 1 case of abnormal renal function， and 1 case of abnormal liver function. The total adverse reactions of the observation group （4.17%） and the control group （6.38%） had no significant difference （χ2=0.233 9， P=0.062 86）. ConclusionMahuang Xixin Fuzitang combined with acupuncture and moxibustion is safe and effective in the treatment of localized scleroderma.

Analysis of the clinical treatment effect of 116 imported falciparum malaria cases in Wuhan City / 公共卫生与预防医学

Objective To analyze and evaluate the clinical characteristics of imported falciparum malaria cases and the antimalarial effect of artemisinin-based drugs, to promote rational and standardized drug use, and to improve the clinical cure rate of falciparum malaria. Methods A total of 116 imported cases of falciparum malaria admitted to the provincial malaria designated hospital in Wuhan were collected, and the clinical characteristics of the patients and use of artemisinin, and the therapeutic effects of the artemisinin-based drugs were retrospectively analyzed. Results The clinical manifestations of imported falciparum malaria were complicated and varied and had many complications, including mainly fever, anorexia, anemia, and jaundice, etc. The symptoms were alleviated or disappeared after treatment with artemisinin, without obvious adverse drug reactions. The median time of fever reduction was 2 days, the median time of Plasmodium becoming negative was 3 days, and the median time of clinical symptom relief was 3 days. 109 cases of common falciparum malaria were treated by oral artemisinin compound or artesunate injection combined with oral artemisinin compound, including 30 cases of oral artemisinin compound treatment for 1 to 4 days (1 case relapsed) and 79 cases of artesunate injection combined with oral artemisinin compound for 4 to 6 days (4 cases relapsed). Seven severe cases were cured after long-term and high-dose treatment with artesunate injection combined with oral multiple artemisinin compounds, and the total cure rate was 95.69% (111/116). Conclusion The present study demonstrates that the treatment of falciparum malaria by oral injection of artemisinin is safe and effective, and the cure rate is high. However, some patients have recurrence of the malaria parasite after stopping artemisinin drugs. It is necessary to ensure the use of artemisinin-based drugs in a “standardized, full-process, and adequate” way to contain the risk of severe illness and drug resistance.

Surgical approach selection and curative effect analysis of orbital cavernous hemangioma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the choice of surgical approach, therapeutic effect and complications of orbital cavernous hemangioma(OCH)in different positions of orbit.METHODS: The clinical data of 128 patients of 128 eyes with OCH whose were surgically removed and pathologically diagnosed in the department of ophthalmology of the Second Affiliated Hospital of Air Force Military Medical University from January 2016 to August 2021 were retrospectively analyzed. The position of OCH in the orbit was determined by preoperative imaging examination(CT/MRI), so as to select different surgical approaches and analyze the postoperative curative effect and the incidence of complications.RESULTS: The location of OCH in the orbit: 82 eyes in the muscle cone and 46 eyes outside the muscle cone. According to the quadrant of the orbit where the tumor was located, there were 24 eyes in the upper-outer quadrant, 38 eyes in the lower-outer quadrant, 28 eyes in the upper-inner quadrant, 12 eyes in the lower-inner quadrant, and 26 eyes the intraconal central space. The selection of surgical approach: 1)OCH in the muscle cone: conjunctival approach surgery in 53 eyes, lateral orbital approach surgery in 22 eyes, lateral combined medial conjunctiva orbital approach surgery in 5 eyes, skin approach surgery in 1 eye, transnasal approach under nasal endoscope surgery in 1 eye; 2)OCH outside the muscle cone: skin approach in 29 eyes, conjunctival approach in 12 eyes and lateral orbital approach in 5 eyes. Postoperative efficacy: except for 1 eye of postoperative tumor residue, the other 127 eyes were completely removed. Postoperative complications: 1)Ocular motility disorder: 16 eyes, including conjunctival approach surgery in 11 eyes, lateral orbital approach surgery in 4 eyes, lateral combined medial conjunctiva orbital approach surgery in 1 eye; 2)Visual acuity decreased in 9 eyes: conjunctival approach surgery in 3 eyes, lateral orbital approach surgery in 6 eyes; 3)Mydriasis occurred in 9 eyes, including 4 eyes via conjunctival approach surgery and 5 eyes via lateral orbital approach surgery; 4)Intraorbital hemorrhage occurred in 3 eyes: all occurred through conjunctival approach surgery; 5)Visual acuity was lost in 2 eyes, including conjunctival approach surgery in 1 eye and lateral orbital opening approach surgery in 1 eye; 6)There were 2 eyes of ptosis, including conjunctival approach surgery in 1 case and skin approach surgery in 1 eye; 7)Tumor residue occurred in 1 eye: multiple intraorbital tumors were treated by lateral orbital approach surgery.CONCLUSION: The accurate location of OCH combined with imaging examination and the selection of appropriate surgical approaches according to different locations can successfully remove the tumor and reduce the incidence of complications.

Study on the effect of music therapy on middle-aged and elderly individuals with depression / Estudo sobre o efeito da terapia musical sobre indivíduos de meia-idade e idosos com depressão / Investigación sobre musicoterapia para la depresión de mediana edad y ancianos

ABSTRACT To explore the clinical effect of music therapy in the treatment of middle-aged and elderly patients with depression. From June 2019 to June 2020, 100 patients with depression in a community were selected as the object of this study, and were divided into a control group and an observation group according to the order of visits, with 50 patients in each group. There was no significant difference between the two groups in terms of gender, age, education level and drug treatment (medication dose, type) (P>0.05). The patients in the control group were treated with conventional antidepressant drugs. The patients in the observation group added music therapy to the conventional therapy. The music therapist needs to fully understand the basic situation of the patient and formulate a suitable music treatment plan according to the actual state of the patient. Compare the HANA and PSP scores between the two groups of depressive patients after treatment to judge the treatment effect on the patients. The Hana and PSP scores in the observation group after treatment were significantly higher than those in the control group (P<0.05). To treat depression, in addition to selecting appropriate drugs, alleviating the emotional state of patients is more important. Music therapy as an auxiliary treatment of traditional therapy, in the treatment of depression in the elderly, has been effectively verified, we should actively promote its application.

RESUMO Explorar o efeito clínico da terapia musical no tratamento de pacientes de meia-idade e idosos com depressão. De junho de 2019 a junho de 2020, 100 pacientes com depressão foram selecionados como objeto deste estudo, e foram divididos em um grupo controle e um grupo de observação de acordo com a ordem de consultas, sendo 50 pacientes incluídos em cada grupo. Não houve diferença significativa entre os dois grupos em termos de gênero, idade, escolaridade e tratamento medicamentoso (dose, tipo de medicação) (P>0.05). Os pacientes do grupo controle foram tratados com medicamentos antidepressivos convencionais. Os pacientes do grupo de observação adicionaram a terapia musical à terapia convencional. O terapeuta musical precisa entender completamente a situação básica do paciente e formular um plano de tratamento musical adequado de acordo com o estado real do paciente. Comparar os escores HANA e PSP entre os dois grupos de pacientes com depressão após tratamento para avaliar o efeito terapêutico dos pacientes. Os escores Hana e PSP no grupo de observação após o tratamento foram significativamente superiores às do grupo controle (P< 0.05). Para o tratamento da depressão, além da seleção de medicamentos apropriados, o estado emocional dos pacientes é mais importante. A terapia musical Como tratamento auxiliar da Terapia tradicional no tratamento da depressão nos idosos foi efetivamente verificada, portanto devemos promover ativamente sua aplicação.

RESUMEN Explorar el Efecto Clínico de la Musicoterapia en el Tratamiento de Pacientes de Mediana Edad y Ancianos con Depresión. Desde junio de 2019 a junio de 2020, se seleccionaron 100 pacientes con depresión en una comunidad como objeto de este estudio, y se dividieron en un grupo de control y un grupo de observación según el orden de visitas, con 50 pacientes en cada grupo. No hubo diferencias significativas entre los dos grupos en términos de sexo, edad, nivel de educación y tratamiento farmacológico (dosis de medicación, tipo) (P> 0,05). Los pacientes del grupo de control fueron tratados con fármacos antidepresivos convencionales. Los pacientes del grupo de observación agregaron la musicoterapia a la terapia convencional. El musicoterapeuta debe comprender completamente la situación básica del paciente y formular un plan de tratamiento musical adecuado de acuerdo con el estado real del paciente. Se compararon las puntuaciones de HANA y PSP entre los dos grupos de pacientes depresivos después del tratamiento para juzgar su efecto del tratamiento en los pacientes. Las puntuaciones de Hana y PSP en el grupo de observación después del tratamiento fueron significativamente más altas que las del grupo de control (P <0,05). Para tratar la depresión, además de seleccionar los fármacos adecuados, es más importante aliviar el estado emocional de los pacientes. La musicoterapia como tratamiento auxiliar de la terapia tradicional, en el tratamiento de la depresión en el anciano, ha sido efectivamente comprobada, debemos promover activamente su aplicación.

Research progress in the treatment of treatment-resistant depression by deep brain stimulation / 四川精神卫生

In recent years， plenty of studies have demonstrated that deep brain stimulation （DBS） has potential efficacy for treatment-resistant depression. This paper reviews the worldwide research progress of DBS in the treatment of treatment-resistant depression， in which the DBS treatment mechanism， targets and outcomes are discussed， the limitations of current DBS treatment are summarized， and the development direction of DBS is also forecasted， therefore providing a factual basis for relevant experiments in China.

An investigation on application of the standard of "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) / 中华地方病学杂志

Objective:To investigate the application and problems existing in the implementation of the standard of "Assessment for Therapeutic Efficacy of Kashin-Beck Disease" (WS/T 79-2011, referred to as new standard), and to provide technical basis and suggestions for further improving the standard.Methods:In 2019, a questionnaire survey was conducted and analyzed in Sichuan, Shaanxi, Qinghai and Gansu provinces and Tibet Autonomous Region on basic information, standard implementation, publicity, training and application of scoring method of joint dysfunction index of Kashin-Beck disease prevention and control technicians.Results:One hundred and thirty-four questionnaires were distributed in this survey and 132 valid questionnaires were recovered, of which 88.64% (117/132) of Kashin-Beck disease prevention and control technicians received training in the new standard and 89.39% (118/132) used the new standard; 78.03% (103/132) thought that the standard terms were clear and easy to master; 71.97% (95/132) thought it was simple, convenient and easy to operate; 49.24% (65/132) thought that the standard evaluation results were consistent with the actual improvement of patients, and 50.75% (67/132) thought that it was generally consistent; 72.73% (96/132) thought that the design was scientific, reasonable and feasible. When using the scoring method of joint dysfunction index, more than 90% of the technicians thought that the five index terms of "joint rest pain", "joint movement pain", "morning stiffness", "maximum walking distance" and "limb activity ability" were easy to understand and ask questions. When patients with Kashin-Beck disease were investigated, the constituent ratios of easy to understand the five index terms were 96.21% (127/132), 83.33% (110/132), 90.15% (119/132), 78.79%(104/132), 90.15%(119/132) and the constituent ratios of easy to answer were 95.45% (126/132), 83.33% (110/132), 89.39% (118/132), 75.00% (99/132) and 89.39% (118/132), respectively.Conclusions:The new standard terms are clear, the design is scientific and reasonable, the operation is convenient and the feasibility is strong. The evaluation results are basically consistent with the actual improvement of patients. It is suggested to add objective evaluation indexes to the scoring method of joint dysfunction index.

Effect of Fuzheng Huayu Capsule on Experimental Non-alcoholic Fatty Liver Fibrosis in Mice / 中国实验方剂学杂志

Objective:To explore the therapeutic effect of Fuzheng Huayu capsule on nonalcoholic fatty liver fibrosis induced by high trans fatty acid and high sugar diet in mice. Method:Forty SPF male C57/B6 mice were randomly divided into 4 groups （normal group， model group， Obelcholinic acid group， and Fuzheng Huayu capsule group）， with 10 mice in each group. Except 10 mice in the normal group， nonalcoholic fatty liver fibrosis was induced by high-fat and high-sugar diet for 24 weeks in the other 30 mice. From the 25th week of modeling， 4 groups received intragastric administration for 4 weeks， once a day： Fuzheng Huayu capsule group 4.8 g·kg^-1. Oxycholic acid group 10 mg·kg^-1. Model control group and normal group received the same volume of normal saline. Liver tissue and serum samples were collected at the end of the 28th week. The pathological changes of liver tissue of mice in each group were observed by hematoxylin-eosin （HE） staining， the degree of liver fibrosis was observed by Sirius red staining， the degree of lipid deposition was observed by oil red O staining， the content of hydroxypropylamine （Hyp） in liver tissue was determined by alkaline hydrolysis， and the change of triglyceride （TG） in liver tissue was detected by enzyme method. Serum alanine aminotransferase （ALT）， aspartate aminotransferase （AST） activities and fasting blood glucose （FBG） were detected by kit method， enzyme-linked immunosorbent assay （ELISA） was used to detect fasting Insulin （INS） level and calculate the changes of insulin resistance index （HOMA-IR）， liver fibrosis related mRNA and proteins of were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， Western blot and Immunohistochemistry. Result:Compared with the normal group， the liver tissue in the model group showed significant collagen fiber deposition， at mostly F2-F3 fibrosis stages， with increased number of inflammatory foci in liver tissue， obvious balloon degeneration and fatty degeneration of liver cells， significantly increased contents of Hyp and TG in liver tissue （<italic>P</italic><0.01）， significantly increased activities of ALT and AST in serum and levels of FBG， INS and HOMA-IR （<italic>P</italic><0.01）， and increased type I collagen （Col-Ⅰ）， Col-Ⅳ， <italic>α</italic>-smooth muscle agonist protein （<italic>α</italic>-SMA） and transforming growth factor-<italic>β</italic> （TGF-<italic>β</italic>） protein and mRNA in liver tissue. Compared with the model group， the collagen fiber deposition in liver tissue of mice in Fuzheng Huayu capsule group was significantly reduced， at mostly F0-F1 fibrosis stages， with significantly improved balloon-like change of hepatocytes， and significantly reduced number of inflammatory foci in lobules （<italic>P</italic><0.05，<italic>P</italic><0.01）. Compared with the model group， Fuzheng Huayu capsule can significantly reduce the content of Hyp in liver tissue， the levels of serum ALT and AST， and the expression of Col-Ⅰ， Col-Ⅳ， <italic>α</italic>-SMA and TGF-<italic>β</italic> genes and proteins in mice （<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:Fuzheng Huayu capsule has a good therapeutic effect on nonalcoholic fatty liver fibrosis induced by high trans fatty acid and high sugar diet in mice.

Evaluation of short-term effect of E-eye intense pulsed light combined with meibomian gland expression in the treatment of meibomian gland dysfunction / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare short-term effectiveness of E-eye IPL combined with meibomian gland expression to simple meibomian gland expression in the treatment of meibomian gland dysfunction(MGD).<p>METHODS: Totally 40 patients with MGD(80 eyes)visiting the Department of Ophthalmology of West China Hospital of Sichuan University from October 2019 to January 2020 were randomly divided into experimental group and control group. Both eyes in the experimental group received IPL combined with meibomian gland expression, while those in the control group received meibomian gland expression only once every 2wk for 3 times. During the whole treatment, patients in the two groups received 0.3% sodium hyaluronate 4 times a day. Metrics were collected before each treatment and 2wk after the last treatment to evaluate the short-term efficacy of IPL combined with meibomian gland expression.<p>RESULTS: OSDI and SPEED scores of the two groups decreased with statistical significance(<i>P</i><0.05), but there was no statistical significance between the two groups(<i>P</i>>0.05). MGE and LLT of both groups increased. The increase in the control group was slower than that in the experimental group. MGE of the experimental group was higher than that of the control group after the second and third treatment, with statistical significance(<i>P</i><0.05). BUT of both groups increased. Corneal staining in both groups decreased, and it decreased more in the experimental group than in the control group, with no statistical significance between the two groups(<i>P</i>>0.05). The visual quality in the two groups improved, but in improving visual quality the experimental group was much better than the control group(<i>P</i>>0.05). There was no significant change in tear secretion, incomplete blink ratio and meibomian gland loss rate in the two groups(<i>P</i>>0.05). There were no skin and visual impairment, intraocular pressure change, anterior segment inflammation and other complications in all subjects.<p>CONCLUSION:IPL combined with meibomian gland expression and meibomian gland expression alone are both safe and effective. IPL, which has good, rapid effects and cumulative effects, works better after reaching a certain number of treatments.

Paradoxical effects of arsenic in the lungs

High levels (> 100 ug/L) of arsenic are known to cause lung cancer; however, whether low (≤ 10 ug/L) and medium (10 to 100 ug/L) doses of arsenic will cause lung cancer or other lung diseases, and whether arsenic has dose-dependent or threshold effects, remains unknown. Summarizing the results of previous studies, we infer that low- and medium-concentration arsenic cause lung diseases in a dose-dependent manner. Arsenic trioxide (ATO) is recognized as a chemotherapeutic drug for acute promyelocytic leukemia (APL), also having a significant effect on lung cancer. The anti-lung cancer mechanisms of ATO include inhibition of proliferation, promotion of apoptosis, anti-angiogenesis, and inhibition of tumor metastasis. In this review, we summarized the role of arsenic in lung disease from both pathogenic and therapeutic perspectives. Understanding the paradoxical effects of arsenic in the lungs may provide some ideas for further research on the occurrence and treatment of lung diseases.