Clinical Efficacy of Kuijietong Against Mild to Moderate Active Ulcerative Colitis / 中国实验方剂学杂志

Objective:To re-evaluate the intervention effect of Kuijietong（KJT） on ulcerative colitis（UC）. Method:Sixty patients with mild-to-moderate UC in the active stage were enrolled and randomized into a KJT group （<italic>n</italic>=30） and a sulfasalazine （SASP） group （<italic>n</italic>=30）. Patients in the KJT group were treated with KJT granules， one bag divided in two daily doses， once in the morning and once in the evening， while those in the SASP group received SASP， 1 g per time， four times per day. Then the clinical efficacy was evaluated. Result:According to the modified Mayo score，the clinical remission rates of the KJT group and SASP group were determined to be 46.7% （14/30）and 40% （12/30），exhibiting no significant difference between the two groups （<italic>P</italic>>0.05）. The clinical effective rate of the KJT group was 83.3% （25/30），which was better than 60% （18/30） of the SASP group （<italic>P</italic><0.05）. The mucosal healing rate in the KJT group was 36.7% （11/30）， not significantly different from 30% （9/30） in the SASP group. In the alleviation of UC symptoms，the score of large intestine dampness heat syndrome in the KJT group was remarkably better than that in the SASP group （<italic>P</italic><0.05），but there was no significant difference in inflammatory bowel disease questionnaire （IBDQ） score between the two groups. In terms of physical and chemical indexes，serum erythrocyte sedimentation rate （ESR） in the KJT group after intervention was lower than that in the SASP group （<italic>P</italic><0.05），whereas the interleukin-10 （IL-10） level was higher（<italic>P</italic><0.05）. The comparison between the two groups revealed no significant difference in C-reactive protein （CRP）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， CD4⁺ T cells and regulatory T （Treg） cells after intervention. During the intervention，no obvious adverse reactions were found in the two groups，indicating good safety. Conclusion:KJT is not inferior to SASP in relieving mild-to-moderate UC in the active stage.

Effect of Kuijietong on Phosphorylation of IkappaBalpha/NF-kappaB p65 Signaling Pathway in Rats with Ulcerative Colitis Induced by Dextran Sulfate Sodium / 广州中医药大学学报

Objective On the basis of previous research, we intended to further explore whether Kuijietong chieving the inhibitory effect on inflammatory action in ulcerative colitis(UC) through inhibiting the phosphorylation of IkappaBalpha/NF-kappaB p65(p-IκBα/NF-κB p65). Methods UC rat model was established by free drinking of dextran sulfate sodium(DSS) water. SD rats were randomly divided into normal group, model group, high-dose Kuijietong group(at intragastric dosage of 15 g·kg-1·d-1), low-dose Kuijietong group(at intragastric dosage of 5 g·kg-1·d-1), SASP group (at intragastric dosage of 0.3 g·kg-1·d-1). After treatment for 2 weeks, the expression levels of p-IκBα/IκBα and p-NF-κB p65/NF-κB p65 in colon tissues were determined by Western blotting method. Results The expression levels of p-IκBα/IκBα and p-NF-κB p65/NF-κB p65 in high-dose Kuijietong group were decreased significantly as compared with those in the model group and western medicine group, the difference being statistically significant(P<0.001). Conclusion Kuijietong has protective effects against inflammation in UC through blocking the activation of NF-κB classic inflammatory pathway, and the effect of high dosage of Kuijietong is the strongest.

Prospects of a comprehensive evaluation system for traditional Chinese medicine services / 中西医结合学报

Traditional Chinese medicine (TCM) is a unique health resource in China and one of the main representative traditional medicines globally. TCM has formed a new way of looking at medical practices, health care, scientific research, education, industry and culture. It focuses on promoting and safeguarding the health of people, with an increasing contribution to economic and social development. Establishing a comprehensive evaluation system in accordance with the characteristics of TCM services could promote the scientific merit and the standardization of services management. This would improve health service quality and the social and economic benefits of TCM. It would broaden the field of TCM services research. It would also provide the basis for the formulation of relevant government policies. This study estimates the prospect of establishing a comprehensive evaluation system of TCM services.

Postoperative adjuvant chemotherapy after neoadjuvant chemoradiation for advanced rectal carcinoma: a meta-analysis / 中华普通外科杂志

Objective To evaluate the impact of postoperative adjuvant chemotherapy on prognosis of patients with advanced rectal carcinoma using a meta-analysis.Methods We searched PubMed to identify literature comparing observation with adjuvant chemotherapy after neoadjuvant chemoradiotherapy and surgery for patients with advanced rectal carcinoma.Data were analysed using Revman 5.0 statistical software.Results Nine trials were included consisting of 6 212 patients:3 421 patients received adjuvant chemotherapy and 2 791 patients did not.The age ranged from 55.6 to 68 years.Adjuvant chemotherapysignificantly affects overall and disease-free survival (P =0.002 and P =0.000 5 respectively) of patientswho had received neoadjuvant chemoradiotherapy.The subgroup analysis which originate from insufficient data reveales ypT0-2 patients and ypT3-4 patients can't benefit from adjuvant chemotherapy.Conclusion Postoperative adjuvant chemotherapy can improve the survival of advanced rectal carcinoma patients after neoadjuvant chemoradiotherapy,but can't increase the survival of pathology complete respone and yPN + patients.

Relief of urinary retention after radical hysterectomy for cervical cancer patients by acupressure: a randomized controlled trial / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study whether acupressure could relieve urinary retention after radical hysterectomy in cervical cancer patients.</p><p><b>METHODS</b>A randomized controlled prospective double-blinded trial was carried out in 107 urinary retention patients undergoing grade III radical hysterectomy. They were assigned to Group A (positive acupoints, 40 cases), Group B (negative acupoints, 32 cases) , and Group C (with no acupoints, 35 cases). All patients received protective 115 000 potassium permanganate sitz bath, 15 - 20 min each time, 3 times per day. Patients in Group A received acupressure at positive points [liniao point and Qihai (RN6)] combined points by syndrome typing [Guanyuan (RN4) , Zhongji (RN3) , Shenshu (BL23) , Zusanli (ST36), Sanyinjiao (SP6), and Taixi (K13)]. Patients in Group B received negative acupressure at sham-acupoints (for adjusting gastrointestinal functions). Patients in Group C only received conventional sitz bath. All medication was performed 3 times per day, 7 days as one therapeutic course, 21 days in total. The residual urine volume was detected. The recovery time for bladder function was recorded. The average residual urine volume was also recorded at day 7, 14, and 21.</p><p><b>RESULTS</b>Compared with Group B and C, the time for ureter retention was shortened for mild and severe CKD patients in Group A (P <0. 01). The residual urine volume was also lessened for mild and severe CKD patients in Group A at day 7, 14, and 21 (P <0.01).</p><p><b>CONCLUSION</b>Cervical cancer patients could relieve urinary retention by self-acupressure after radical hysterectomy.</p>

Penile necrosis resulting from post-circumcision microwave diathermy: A report of 9 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the pathogenesis and treatment of penile necrosis resulting from microwave diathermy following circumcision.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data about 9 cases of penile necrosis resulting from postoperative microwave diathermy following circumcision. The 9 males, aged 20 - 39 (mean 26) years, underwent traditional circumcision for redundant prepuce or phimosis in other hospitals, followed by microwave diathermy for 30 - 60 minutes daily, which resulted in penile necrosis. With no response to conservative therapy, the patients were referred to our hospital at 3 -30 days postoperatively. Of the 9 patients, 5 presented with dry gangrene and 4 with moist gangrene. Six of the patients underwent partial penectomy, including 1 that received penis lengthening.3 months later, while the other 3 underwent total penectomy for total penile necrosis followed by penile reconstruction 3 months later, with deep inferior epigastric perforator (DIEP) flaps and by implantation of the 12th costal cartilage in 2 cases and with epigastric groin island flaps and by urethroplasty in the other.</p><p><b>RESULTS</b>The patients were followed up for 2 - 8 years, and all could urinate smoothly in the standing position. Of the 6 men treated by partial penectomy, 1 received penis lengthening and achieved a penile length of 7 cm and 5 had the remaining penile length of 3 -5 cm, 4 with erectile function and the other 2 capable of sexual intercourse. The 3 men treated by total penectomy achieved nearly normal external appearance of the penis, with a finalized length of (11.7 ± 1.3) cm, a circumference of (11.4 ± 2.1) cm, and a normal feel of the skin. Of the 3 cases of penile reconstruction, 2 achieved sufficient erectile hardness of the penis (grade 3) for sexual intercourse, while the other 1 remained impotent.</p><p><b>CONCLUSION</b>Post-circumcision microwave diathermy may result in penile necrosis, for the management of which, early debridement is necessitated and penile lengthening or reconstruction can be performed according to the severity of the lesion and needs of the patient.</p>

Clinical Analysis of Cytomegalovirus Infection after Different Patterns of Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical difference of cytomegalovirus (CMV) infection between HLA-matched allogeneic hematopoietic stem cell transplantation (allo-HSCT) and haploidentical hematopoietic stem cell transplantation (hi-HSCT).</p><p><b>METHODS</b>The clinical data of 83 patients who had undergone allo-HSCT were retrospectively analyzed. Out of them 50 patients underwent hi-HSCT and 33 patients received grafts from HLA-matched donors. The sera of all recipients and donors were CMV-negative before transplantation. All patients accepted myeloablative regimen without total body irradiation. PCR was performed to detect CMV in the peripheral blood twice a week after neutrophil recovery. CMV-DNA>500 copies/ml was defined as CMV viremia.</p><p><b>RESULTS</b>68 patients (81.9%) were diagnosed as CMV viremia before 100 days after transplantation. The incidence of CMV infection in hi-HSCT group was 90% and significantly higher than that in HLA-matched HSCT group (69.7%) (P < 0.05). All the patients responded well to anti-CMV therapy; however, 63 cases experienced CMV reactivation. The occurrence rate of CMV reactivation in hi-HSCT group (95.6%) was comparable to that in HLA-matched HSCT group (87.0%) (P > 0.05). Univariate analysis showed that the transplantation pattern, the recovery time of peripheral neutrophils and the occurrence of acute graft-versus-host disease (aGVHD) significantly related to the episode of CMV viremia, while the sex and age of the recipients, and the recovery time of platelets did not associate with the incidence. Further analysis found that the recovery time of neutropils and platelets in HLA-matched HSCT group were greatly shorter than those in hi-HSCT group (P < 0.05). The incidence of aGVHD was comparable between two groups however, incidence of severe aGVHD was significantly higher in hi-HSCT (P < 0.05).</p><p><b>CONCLUSION</b>The hi-HSCT is more susceptible to CMV infection, which may be related to the higher incidence of severe aGVHD and the relative delay of hematopoietic reconstruction as compared with HLA-matched HSCT.</p>

Hand-assisted-drawing-needle running suture with a curved needle: an effective technique to create a W-ileal neobladder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An important milestone in the area of urinary diversion was the advent of a series of orthotopic bladder substitution (OBS). However, reconstruction of OBS by the traditional hand suture method (THSM) is a time-consuming process. Stapling techniques are considered to be inferior to hand-sewn methods. We report our experience and functional results in patients with W-ileal neobladder by a hand-assisted-drawing-needle running suture (HADNRS).</p><p><b>METHODS</b>Between April 1993 and December 2011, 347 patients (338 men and 9 women) aged 28 - 77 years (median age: 59 years) underwent radical cystectomy, followed by the creation of a modified W-ileal neobladder by HADNRS with a curved needle. A total of 347 (20 patients in 2003) were evaluated by urodynamic tests.</p><p><b>RESULTS</b>The operative time ranged from 110 to 310 minutes (mean 148 minutes), and the mean time of reconstruction by HADNRS, excluding ureterointestinal and ileouretral anastomosis, was (20.2 ± 4.3) minutes. Histopathological analysis of removed specimens showed that 317 patients had transitional cell bladder carcinoma. Of these 317 patients, 19 also had squamous carcinoma and 13 had adenocarcinoma. Glandularis and prostate cancer occurred in 16 and 14 patients, respectively. Three patients (0.8%) had neobladder abdominal fistula. No other early complications or injury to the surgeon's hands occurred due to HADNRS. Of the 20 cases with urodynamic examinations in 2003, two suffered from daytime incontinence and six had nocturnal incontinence. The maximum capacity of the neobladder was (492.9 ± 177.8) ml, and the maximum pressure within the reservoir at the end of filling was (32.1 ± 8.6) cmH2O.</p><p><b>CONCLUSION</b>Reconstruction of W-ileal neobladder by HADNRS is effective and economical.</p>

Deposition of insulin powders for inhalation in vitro and pharmacodynamic evaluation of absorption promoters in rats / 药学学报

<p><b>AIM</b>To prepare insulin powder for inhalation by spray-drying technology, determine the deposition of the insulin powder formulation in vitro and preliminarily investigate hypoglycemic response of the dry powder with/without absorption promoters.</p><p><b>METHODS</b>The depositions of the insulin powder for inhalation were determined by the China Pharmacopoeia 2000 version addenda XH and hypoglycemic effects were evaluated by testing serum glucose with glucose oxidase-peroxidase (GOD-PAP) method.</p><p><b>RESULTS</b>The depositions of the spray-dried insulin powder for inhalation were more than 40% under various humidity and their changes were not significant when air flow was no less than 18 L x min(-1). The coadministration of insulin with 8 mmol x L(-1)/dose sodium taurocholate [PA = 59.91%, Cnadir = (33 +/- 6) %] and 10 mmol x L(-1)/dose sodium deoxycholate [PA = 47.46% , Cnadir = (32 +/- 7)%] induced a significantly greater decline in blood glucose levels, while coadministration with 1% sodium caprylate, 1% sodium dodecyl sulfate, 250 microg/dose lecithin, 10 mmol x L(-1)/dose EDTA appeared to have no significant effect (P > 0.05).</p><p><b>CONCLUSION</b>Insulin powder for inhalation was relatively stable under various humidity conditions and different flow current. The use of 8 mmol x L(-1)/dose sodium taurocholate and 10 mmol x L(-1)/dose sodium deoxycholate could be able to potentially improve the bioavailability of insulin by pulmonary route.</p>

Diagnosis of the testicular tumor (57 case reports) / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the diagnosis of the testicular tumor.</p><p><b>METHODS</b>Fifty-seven cases, including their signs and symptoms, imaging studies, tumor markers and histologic diagnoses, were reviewed.</p><p><b>RESULTS</b>31.3% of the patients failed to go to hospital in time. B mode ultrasound and CDFI had sensitivity of 93.5% and 96.4% respectively. Compared with final diagnoses, 23 from 26 cases (88.5%) were correspondingly diagnosed by intraoperative frozen section examination (FSE), which, however, had no definitive influence on the surgical management. Histologic examination showed 22 patients with seminoma, 9 with embryonal carcinoma, 7 with teratoma, 3 with yolk sac tumor, 9 with combined patterns, 4 with lymphoma, and 3 with other histologic types of tumor.</p><p><b>CONCLUSIONS</b>For earlier diagnosis, patients testicular self-examination counts for much, and ultrasound and CT should be used before possible histologic examination, while all patients with testicular tumors should have intraoperative FSE, which is very practical in identifying malignant and benign masses, and in choosing between enucleation of the tumor and radical orchiectomy.</p>

Retroperitoneal iaparoscopic partial nephrectomy(report of 23 cases) / 中华泌尿外科杂志

Objective To report initial experience and the indications of retroperitoneal laparoscop- ic partial nephrectomy.Methods From December 2001 to October 2005,23 patients (including 14 cases of renal cell carcinoma,5 of hamartoma and 4 of duplex kidney) underwent retroperitoneal laparoscopic par- tial nephrectomy.One of the patients had solitary kidney.Results All the operations were successful ex- cept for only 1 requiring conversion to laparoscopic nephrectomy because of bleeding resulting from blocking anterior branch of renal artery.The mean operative time was 121 min (60-240 min),and mean ischemic time was 32 min (20-55 min).The estimated bleeding volume ranged from 100 ml to 300 ml,and no pa- tient needed blood transfusion.Pathology showed negative surgical margins in 14 cases of renal cell carcinoma and confirmed the diagnosis of hamartoma in 5 cases.One patient with duplex kidney required open partial nephrectomy because of renal cystic mass resulting from incomplete resection.Conclusions Retroperito- neal laparoscopic partial nephrectomy offers a new effective and minimally invasive treatment for selected pa- tients with renal mass.The long-term effects of the procedure need further investigation.