Analysis of Chinese Medical Syndrome Features of Ischemic Stroke Based on Similarity of Symptoms Subgroup / 中国结合医学杂志

OBJECTIVE@#To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients.@*METHODS@#By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup.@*RESULTS@#Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens.@*CONCLUSIONS@#There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.

Clinical effectiveness of live preparation of lactobacillus in treatment of bacterial vaginosis in pregnancy: A meta-analysis

Objective: To evaluate the clinical effectiveness of live preparation of lactobacillus in treatment of bacterial vaginosis in pregnancy. Methods: Randomized controlled trials of live preparation of lactobacillus in the treatment of bacterial vaginosis in pregnancy were collect by searching PubMed, Web of Science, OVID, CNKI, WanFang, VIP, CBM and Elsevier databases. Quality of the included trials were evaluated by two researchers independently, and data were extracted according to Cochrane systematic evaluation. RevMan 5.3 software was used for meta-analysis. Results: Twenty-one randomized controlled trials involving 2 930 patients were included, which showed that there was significant difference in the clinical effectiveness between vaginal medication of live preparation of lactobacillus and vaginal medication of metronidazole [total effective rate (RR=1.05, 95% CI: 1.02-1.07, P=0.000 4]; significant differences were found in premature delivery rate (RR=0.49, 95% CI: 0.32-0.73, P=0.000 4), premature rupture of membrane rate (RR=0.54, 95% CI: 0.38-0.77, P=0.000 7), infant of low-birth weight rate (RR=0.45, 95% CI: 0.22-0.94, P=0.03), puerperal infection rate (RR=0.60, 95% CI: 0.39-0.94, P=0.03) between the two groups. Conclusions: Vaginal medication of live preparation of lactobacillus was more clinically effective than vaginal medication of metronidazole for bacterial vaginosis in pregnancy. Live preparation of lactobacillus is associated with a lower premature delivery rate, a lower premature rupture of membrane rate, a lower low-birth weight rate and a lower puerperal infection rate.

Comparison of efficacy of two surgical resection methods for hilar cholangiocarcinoma: A systematic review

Objective: To systematically analyze the prognosis of limited hilar hepatectomy versus combined liver lobectomy in the treatment of hilar cholangiocarcinoma. Methods: We searched CBM, CNKI, VIP, Wangfang, PubMed, SCI, Elsevier clinicalkey and OVID, and the cut-off time of searching was 31 April, 2019. Two researchers evaluated the risk of bias of the included studies independently according to the Newcastle-Ottawa Scale (NOS), and extracted data. RevMan 5.3 software was used for meta-analysis. Results: A total of 12 cohort studies involving 1 288 patients were included, of which 426 patients were in the limited hilar hepatectomy group and 862 patients in the combined liver lobectomy group. Meta-analysis showed that there were statistically significant difference in radical resection rate and postoperative complication rate (RR=0.55, 95%CI 0.40 to 0.74, P<0.001; RR=0.63, 95%CI 0.49 to 0.81, P<0.001) between the hilar limited hepatectomy group and the combined liver lobectomy group; significant differences were found in 1-, 2- and 3-year survival rates (RR=0.75, 95%CI 0.67 to 0.84, P<0.001; RR=0.55, 95%CI 0.42 to 0.74, P<0.001; RR=0.54, 95%CI 0.39 to 0.75, P<0.001) between the two groups. Conclusions: Comparing with the limited hilar hepatectomy, the radical resection rate of combined liver lobectomy was higher, and the 1-, 2- and 3-year survival rates were improved, but the complications was increased in treatment of hilar cholangiocarcinoma.

Diffusion weighted imaging combined with magnetic resonance conventional sequences for the diagnosis of rectal cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the clinical value of diffusion weighted imaging (DWI) combined with conventional sequences of magnetic resonance imaging (T1 and T2-weighted imaging) for the diagnosis of rectal cancer.</p><p><b>METHODS</b>DWI and conventional sequences were performed in 29 patients with endoscopically diagnosed rectal cancer and 15 patients without rectal cancer. Two doctors who were blind to the history of the patients interpreted the imaging findings. The sensitivity and specificity of conventional sequences with and without DWI were analyzed using receiver operating characteristic curve (ROC).</p><p><b>RESULTS</b>The areas under ROC were 0.915 and 0.930 for conventional sequences alone, and 0.990 and 0.994 for conventional sequences with DWI, respectively, indicating that although both of them were optimal methods for the diagnosis of rectal cancer, the accuracy of conventional sequences with DWI was significantly superior to that of conventional sequence alone (P < 0.05). The Kappa value was 0.850 for conventional sequences alone and 0.858 for DWI with conventional sequences.</p><p><b>CONCLUSION</b>DWI was necessary for the diagnosis of rectal cancer when performing conventional sequences.</p>

Measurement of glutamine concentration in Zelanian rabbits' skeletal muscle by non-invasive magnetic resonance spectroscopy / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the feasibility of non-invasive magnetic resonance spectroscopy (MRS) in measuring glutamine (GLN) level in Zelanian rabbits' skeletal muscle.</p><p><b>METHODS</b>Non-invasive MRS was used to get the data of peak height ratio of GLN + glutamic acid (GLx) at 3.8 ppm and creatine (Cr) at 3.0 ppm, peak area ratio of GLx at 3.8 ppm and Cr at 3.0 ppm. High performance liquid chromatography (HPLC) was used to examine the actual GLx levels of muscle from 22 Zelanian rabbits. The feasibility of MRS was then evaluated by HPLC method.</p><p><b>RESULTS</b>The ratio of peak height and peak area of GLx and Cr by means of MRS were 0.162 +/- 0.045 and 0.092 +/- 0.065, respectively. The average concentration of GLx in skeletal muscle by means of HPLC was (4.19 +/- 2.50) micromol/g. The ratio of GLx and plasma Cr level by means of HPLC was 4.576 -/+ 0.599. The ratio of peak height and peak area of GLx and Cr by means of MRS were correlated significantly with the ratio of concentration of GLx in skeletal muscle and plasma Cr by means of HPLC (r = 0.7, P = 0.001; r = 0.6, P = 0.001).</p><p><b>CONCLUSION</b>Non-invasive MRS is feasible to measure GLN level in skeletal muscle of rabbit.</p>

Differences in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with fair at 3. 0T / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence.</p><p><b>METHODS</b>Nine patients with refractory temporal lobe epilepsy, 21 patients with non-refractory temporal lobe epilepsy, and 13 normal volunteers underwent FAIR MR scanning. The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured. And we also calculated the asymmetry index (AI) values.</p><p><b>RESULTS</b>The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P = 0.012 and 0.029, respectively). There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P = 0.049), while no significant difference between refractory epilepsy patients and volunteers.</p><p><b>CONCLUSIONS</b>The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients. Although the hypoperfusion tends to extend out of temporal lobes in all patients, the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion, which may be valuable for evaluating prognosis.</p>

Evaluation of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes with magnetic resonance imaging and proton magnetic resonance spectroscopy / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To study the characteristics of spectra on proton magnetic resonance spectroscopy (1H-MRS) and its value in patients with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS).</p><p><b>METHODS</b>Seven clinically diagnosed patients with MELAS underwent magnetic resonance imaging (MRI) and 1H-MRS examinations. The 1H-MRS techniques, characteristics of the spectra, and its correlation with the laboratory tests were analyzed.</p><p><b>RESULTS</b>Cerebral abnormalities were revealed in all 7 patients on conventional MR images, and most abnormal signals were observed in bilateral occipital, parietal, and temporal lobes. We found 4 cases with basal ganglia involvement, 2 cases with mild frontal lobe lesions, and 1 case with involvement of lateral cerebral peduncles and thalami. Additionally, 1 patient was involved with left insular lobe. Spectra from prominent lesions in brain parenchyma showed lactate doublet peak in 6 patients, 3 of whom were also noted lactate peak in ventricular cerebrospinal fluid (CSF).</p><p><b>CONCLUSION</b>1H-MRS may provide more direct information about the metabolism changes, which aids to affirm the diagnosis, and may replace the conventional invasive method of quantifying lactate in CSF.</p>