Endoscopic botulinum toxin injection combined with balloon dilatation for treatment of cricopharyngeal achalasia in patient with brainstem stroke / 中南大学学报(医学版)

OBJECTIVES@#At present, there are many reports about the treatment of cricopharyngeal achalasia by injecting botulinum toxin type A (BTX-A) into cricopharyngeal muscle guided by ultrasound, electromyography or CT in China, but there is no report about injecting BTX-A into cricopharyngeal muscle guided by endoscope. This study aims to evaluate the efficacy of endoscopic BTX-A injection combined with balloon dilatation in the treatment of cricopharyngeal achalasia after brainstem stroke, and to provide a better method for the treatment of dysphagia after brainstem stroke.@*METHODS@#From June to December 2022, 30 patients with cricopharyngeal achalasia due to brainstem stroke were selected from the Department of Rehabilitation Medicine, the First Hospital of Changsha. They were randomly assigned into a control group and a combined group, 15 patients in each group. Patients in both groups were treated with routine rehabilitation therapy, while patients in the control group were treated with balloon dilatation, and patients in the combined group were treated with balloon dilatation and BTX-A injection. Before treatment and after 2 weeks of treatment, the patients were examined by video fluoroscopic swallowing study, Penetration-aspiration Scale (PAS), Dysphagia Outcome Severity Scale (DOSS), and Functional Oral Intake Scale (FOIS) were used to assess the swallowing function.@*RESULTS@#In the combined group, 1 patient withdrew from the treatment because of personal reasons. Two weeks after treatment, the scores of DOSS, PAS, and FOIS in both groups were better than those before treatment (all P<0.01), and the combined group was better than the control group (all P<0.001). The effective rate was 85.7% in the combined group and 66.7% in the control group, with no significant difference between the 2 groups (P>0.05).@*CONCLUSIONS@#BTX-A injection combined with balloon dilatation is more effective than balloon dilatation alone in improving swallowing function and is worthy of clinical application.

Effects of Xuanyinning Recipe on invasion of SPC-A-1 cells and pathomorphological changes of peritoneum in mice inoculated with sarcoma 180 / 中西医结合学报

OBJECTIVE: To observe the effects of Xuanyinning Recipe (XYNR) in inhibiting SPC-A-1 cellular infiltration and on the pathomorphological changes of peritoneum in mice inoculated with sarcoma 180 (S(180)). METHODS: On the bases of isolated culture of mouse peritoneal mesothelial cells, we adjusted and added the human lung adenocarcinoma cell line SPC-A-1 into the double-layer culture medium to observe the number of clones formed. We also took out the peritoneum from the mice administered with three different dosages of XYNR and observed its pathomorphological changes with transmission electron microscope. RESULTS: In the in vitro experiment, the number of clones of SPC-A-1 in culture medium with XYNR (50 microg/ml) decreased distinctly. In the in vivo experiment, it was observed that, in the peritoneum from the XYNR-treated mice inoculated with S(180), the mesothelial cells arranged more and more regularly with the increasing of the dosage of XYNR, while the mesothelial cells in the peritoneum of the mice in the control group necrosed and arranged loosely. CONCLUSION: XYNR can inhibit the invasion of SPC-A-1 cells. It also can improve the loose arrangement of the peritoneal mesothelial cells in mice inoculated with S(180), so as to inhibit the malignant effusion.