Treatment of oral submucous fibrosis with local injection of salvia miltiorrhiza combined with triamcinolone acetonide: a meta-analysis / 口腔疾病防治

Objective@#To evaluate the efficacy of the local injection of Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone in the treatment of oral submucous fibrosis (OSF). @*Methods@# A meta-analysis was performed by searching the related literature. Three randomized controlled trials meeting the inclusion criteria were identified. Changes in the Visual Analogue Scale (VAS) score and the degree of mouth opening were included in 172 cases (86 cases in the experimental group and 86 in the control group), and changes in the oral mucosal lesion area were included in 152 cases (76 cases in the experimental group and 76 in the control group). Changes in the VAS score, the degree of mouth opening and the oral mucosal lesion area were compared in the context of the local injection of Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone.@*Results @# There were no significant differences between the treatment with Salvia miltiorrhiza combined with triamcinolone acetonide and triamcinolone acetonide alone in reducing the VAS score (P > 0.05). Salvia miltiorrhiza combined with triamcinolone acetonide resulted in a greater increase in the degree of mouth opening than did triamcinolone acetonide (P = 0.05). The reduction in the oral mucosal lesion area induced by Salvia miltiorrhiza combined with triamcinolone acetonide was significantly greater than that induced by triamcinolone acetonide alone (P < 0.05). @*Conclusion@#The local injection of Salvia miltiorrhiza combined with triamcinolone acetonide is more effective than triamcinolone acetonide alone in the treatment of OSF.

Risk of congenital anomalies associated with antithyroid treatment during pregnancy: a meta-analysis

To evaluate the association of either propylthiouracil or methimazole treatment for hyperthyroidism during pregnancy with congenital malformations, relevant studies were identified by searching Medline, PubMed, the Cochrane Library and EMBASE. We intended to include randomized controlled trials, but no such trials were identified. Thus, we included cohort studies and case-control studies in this meta-analysis. A total of 7 studies were included in the meta-analyses. The results revealed an increased risk of birth defects among the group of pregnant women with hyperthyroidism treated with methimazole compared with the control group (odds ratio 1.76, 95% confidence interval 1.47-2.10) or the non-exposed group (odds ratio 1.71, 95% confidence interval 1.39-2.10). A maternal shift between methimazole and propylthiouracil was associated with an increased odds ratio of birth defects (odds ratio 1.88, 95% confidence interval 1.27-2.77). An equal risk of birth defects was observed between the group of pregnant women with hyperthyroidism treated with propylthiouracil and the non-exposed group (odds ratio 1.18, 95% confidence interval 0.97-1.42). There was only a slight trend towards an increased risk of congenital malformations in infants whose mothers were treated with propylthiouracil compared with in infants whose mothers were healthy controls (odds ratio 1.29, 95% confidence interval 1.07-1.55). The children of women receiving methimazole treatment showed an increased risk of adverse fetal outcomes relative to those of mothers receiving propylthiouracil treatment. We found that propylthiouracil was a safer choice for treating pregnant women with hyperthyroidism according to the risk of birth defects but that a shift between methimazole and propylthiouracil failed to provide protection against birth defects. .

Integrated treatment of traditional Chinese medicine and western medicine for early- and intermediate-stage diabetic nephropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the therapeutic effect of traditional Chinese herbal medicinal preparation Tangshenqing (TSQ) combined with alprostadil in the treatment of early- and intermediate-stage diabetic nephropathy (DN).</p><p><b>METHODS</b>One hundred and twenty DN patients were randomized into 3 groups for different treatment protocols. The patients in the control group were given the basic treatment (low-protein diabetic diet and rigorous control of blood glucose, blood pressure, and blood fatty acid), and those in treatment group A received TSQ (containing Astragalus membranaceus, Panax notoginseng, Epimedium brevicornum, etc) in addition to the basic treatment, and those in treatment group B were treated with alprostadil injections (for 14 consecutive days) in addition to the treatment given in group A. Therapeutic effect evaluation was carried out after a 30-day treatment in all the patients.</p><p><b>RESULTS</b>The overall efficaey rate of the treatment was 78.37% in the control group, 88.57% in the treatment group A, and 94.44% in treatment group B, suggesting better therapeutic effect in the latter two groups than in the control group (P<0.05). Patients in all the 3 groups exhibited symptomatic improvement of various degrees, but the treatment group B had the best results. After the treatments, the patients' blood glucose and fatty acids were lowered, without obvious difference between the 3 groups. Compared with the control group, the patients in the two treatment groups showed significant reduction in fibrinogen, 24-h urine microprotein and urine protein after the treatment (P<0.01 or 0.05).</p><p><b>CONCLUSION</b>Combined use of traditional Chinese herbal medicine TSQ and alprostadil injections produces definite therapeutic effect on early- to intermediate-stage DN.</p>

Diagnosis and treatment of Hashimoto’s disease complicated with thyroid cancer / 中国癌症杂志

Purpose:To investigate the pathogenesis,diagnos is and treatment of hashimoto's disease(HD) complicated with papillary thyroid c ancer (PTC ). Methods:Clinical data of 12 cases of HD complicated with PTC un dergoing surgery were analysed retrospectively and followed-up for one half to 8 years. Results:In this series papillary thyroid cancer occurred in 25 % (12/48) in patients with HD, but correct preoperative diagnosis was obtained i n 3 (25%) of 12 cases.All patients had thyroid nodules and received thyroidectom y,3 cases underwent functional cervical clearance of lymph nodes. All patients w ere followed up for 6 months to 8 years and there was no death , no recurrence and no metastasis. Conclusions:HD can develop into PTC .The clinical diagnosis of coexistence of HD and PTC is still difficult. The key to diagnosis and rational treatment includes detailed understanding its clinical features, routine examin ation of serum antibodies and ultrasonography, selected scintigraphic thyroid s can or FNAB and finally quick frozen pathologic section in operation. HD complic ated with PTC should be treated surgically.Intraoperative frozen section diagnos is should be performed routinely so that HD complicated with PTC can be diagnose d.The operation procedure should be individualized.All patients should be given small dosage of thyroxine.