Clinical evaluation study on long-term effect of acupuncture with pattern/syndrome differentiation on functional dyspepsia / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy difference in the treatment of functional dyspepsia between acupuncture at the acupoints selected by pattern/syndrome differentiation and domperidone.</p><p><b>METHODS</b>Seventy cases were randomized into an acupuncture group (35 cases) and a western medication group (35 cases). In the acupuncture group, Zusanli (ST 36) and Neiguan (PC 6) were selected. Taichong (LR 3) and Neiting (ST 44) were added for excess syndrome while Gongsun (SP 4) and Yinlingquan (SP 9) were added for deficiency syndrome. A pair of electrodes was attached to one acupoint and an assistant point (2 mm next to the acupoint centripetally) and stimulated with disperse-dense wave at 2 Hz/100 Hz, once a day. In the western medication group, domperidone was prescribed for oral administration, 10 mg each time, three times a day. In the two groups, the treatment of 5 days made one session and 4 sessions were required totally. Nepean dyspepsia index (NDI) was compared after treatment, 1, 2, 3, 4 and 5 months after treatment between the two groups respectively.</p><p><b>RESULTS</b>The score of symptom and score of life quality in NDI after treatment and at each follow-up time point were improved obviously in the acupuncture group as compared with those before treatment (all P < 0.01). In the western mediation group, the score of symptom and the score of life quality in NDI after treatment and in follow-up of 1, 2 and 3 months were improved obviously as compared with those before treatment (all P < 0.01), but the differences were not significant in follow-up of 4 and 5 months (both P > 0.05). Compared with the western medication group, the symptom score of NDI was reduced obviously after treatment and in each time point of follow-up in the acupuncture group (P < 0.05, P < 0.01), and the score of life quality was increased obviously (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>Acupuncture at the acupoints selected by pattern/syndrome differentiation and domperidone are effective in the treatment of functional dyspepsia. Domperidone is unsatisfactory in the long-term effect, but acupuncture achieves the positive short-term and long-term effects on functional dyspepsia.</p>

Clinical analysis of primary gastric diffuse large B-cell lymphoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and prognostic factors of primary gastric diffuse large B-cell lymphoma (PG-DLBCL) and to evaluate the staging system and treatment modality of PG-DLBCL.</p><p><b>METHODS</b>The clinicopathological data of 69 patients with PG-DLBCL were retrospectively analyzed. Event-free survival (EFS) and overall survival (OS) were the primary endpoints.</p><p><b>RESULTS</b>The EFS rates at 1, 3, and 5 years were 83.8%, 71.1%, and 69.0%, respectively, with a mean EFS of 91.3 months. The 1-, 3-, and 5-year OS rates were 91.3%, 80.3%, and 72.4%, respectively, with a mean OS of 98.8 months. Univariate analysis revealed that either EFS or OS was significantly prolonged by the following factors (P < 0.05): modified Ann Arbor stage I(E) or II(E1) disease; normal lactate dehydrogenase (LDH) level; normal hemoglobin level; normal albumin level; International Prognostic Index (IPI) of 0 or 1; tumor size < 5 cm; and less depth of invasion. While gender, age, B symptoms at presentation, performance status and treatment modality were not significantly associated with the prognosis (P > 0.05). Cox regression model revealed that only modified Ann Arbor stage and albumin level were independent prognostic factors for EFS and OS.</p><p><b>CONCLUSION</b>The most accurate staging system and the exact role of different therapeutic options for PG-DLBCL are still debated. Further randomized prospective studies with a large number of patients are still needed to establish an optimal management for this disease.</p>

Water mobility of diffusion MRI in prediction of response to chemoembolization in liver cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the value of pretreatment and posttreatment changes of apparent diffusion coefficients (ADCs) in predicting response to chemoembolization in liver cancer.</p><p><b>METHODS</b>Patients with liver cancer were examined with diffusion-weighted MRI at two b values (0 and 500 s/mm(2)) before and after chemoemblization. Quantitative ADC maps were calculated using images under b values of 0 and 500 s/mm(2). The mean ADC values of lesions before and after chemoemblization were compared. The correlation of response to chemoembolization with ADC value was analyzed.</p><p><b>RESULTS</b>The mean value of pretreatment ADC in non-responding lesions were significantly higher than that in the responding lesions (1.687 x 10(-3) mm(2)/s vs. 1.278 x 10(-3) mm(2)/s, P < 0.05). The results of receiver operator characteristic (ROC) analysis showed that when a threshold ADC value was set on 1.618 x 10(-3) mm(2)/s, the sensitivity and specificity for identification of non-responding lesions were 96.0% and 77.8%, respectively. After transarterial chemoembolization, the responding lesions had a significant increase in ADC values than non-responding lesions (32.6% vs. 5.2%, P = 0.025). The results of ROC analysis indicated that when the changes of ADC value for identification of responding lesions before and after transarterial chemoembolization was > or = 16.2%, the sensitivity and specificity were 72% and 100%, respectively. However, no significant change was observed in normal liver parenchyma and spleen (P > 0.05).</p><p><b>CONCLUSION</b>Pretreatment mean ADC value can be used to predict the response to chemoembolization, and for selection of therapy in liver cancer. A significant increase in mean ADC can be observed if the lesions responds to chemoembolization.</p>