Clinical Effect of Erchentang and Bixie Fenqingyin Combined on Patients with Acute Cerebral Infarction with Hyperuricemia with Syndrome of Phlegm and Blood Stasis Blocking Collaterals / 中国实验方剂学杂志

ObjectiveTo explore the clinical efficacy and safety of the combination of Erchentang and Bixie Fenqingyin in the treatment of patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome to provide a new method and evidence for the treatment of acute cerebral infarction with hyperuricemia. MethodA total of 132 eligible patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome admitted to the Putuo Hospital of Shanghai University of Traditional Chinese Medicine（TCM） from May 2021 to May 2022 were randomly divided into a Chinese medicine group， a western medicine group， and a control group， with 44 cases in each group. All three groups received routine western medical treatment for acute cerebral infarction. Additionally， the Chinese medicine group received Erchentang combined with Bixie Fenqingyin， the western medicine group received Benzbromarone tablets， and the control group did not receive any uric acid-lowering treatment. The treatment duration was four weeks. The modified Rankin Scale （mRS） score after three months of onset， as well as the National Institutes of Health Stroke Scale （NIHSS） scores， TCM syndrome scores， serum uric acid （SUA） levels， serum C-reactive protein （CRP） and interleukin-6 （IL-6） levels， serum superoxide dismutase （SOD） and malondialdehyde （MDA） levels， and other safety indicators were observed before and after treatment. ResultA total of 129 cases completed the trial observation， with 43 cases in the Chinese medicine group， 42 cases in the western medicine group， and 44 cases in the control group. The rate of good prognosis in the Chinese medicine group （83.7%，36/43） was higher than that in the western medicine group （64.3%，27/42） and the control group （40.9%，18/44） （χ2=4.184，16.930，P<0.05）， and the western medicine group was superior to the control group （χ2=4.707，P<0.05）. After treatment， the NIHSS scores， TCM syndrome scores， SUA， CRP， IL-6， and MDA levels of the patients in all three groups decreased， while the SOD levels increased compared with those before treatment （P<0.05）. Among them， the improvement in NIHSS score was better in the Chinese medicine group and the western medicine group than in the control group （P<0.05）. The Chinese medicine group showed the greatest improvement in TCM syndrome （P<0.05）， while the western medicine group showed the greatest reduction in uric acid levels （P<0.05）. No significant abnormalities in safety indicators were observed before and after treatment in the three groups， and no serious adverse reactions were reported. ConclusionThe combination of Erchentang and Bixie Fenqingyin can significantly improve the prognosis， early neurological deficits， and TCM syndromes of patients acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome. It can also lower uric acid levels and inhibit inflammatory and oxidative stress reactions.

Strategies and skills of reoperation for recurrent carcinoma at anastomotic stoma after total gastrectomy / 中华普通外科杂志

Objective:To evaluate the strategy and skills of reoperation for recurrent carcinoma at the stoma of esophagojejunostomy after total gastrectomy.Methods:The management experience in 18 patients at the Department of General Surgery, Tumor Hospital of Zhengzhou University from Oct 2016 to Jul 2021 were analyzed retrospectively.Results:Thirteen patients underwent left thoracoabdominal combined incision to completely remove the tumor.One patient developed anastomotic leakage, two patients developed pulmonary infection, one patient developed costochondritis, all were cured and discharged after conservative treatment; Nine patients had no postoperative complications. Two patients abandoned surgery due to high position of the tumor, 3 patients due to poor cardiopulmonary function, and were given radiotherapy and chemotherapy.The postoperative follow-up period was 4.6 to 42.9 months. Four patients died of tumor recurrence, and the remaining patients survived until the end of the follow-up. The overall 1-and 3-year recurrence-free survival rates were 100% and 20%, respectively.Conclusion:Surgery on recurrent carcinoma at esophagojejunostomy stoma after total gastrectomy, although difficult and challenging,could still benefit most patients when at the hands of expertise.

Correlation between hyperuricemia and outcome in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the relationship between hyperuricemia and outcome in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to Department of Neurology, Putuo Hospital, Shanghai University of Tranditional Chinese Medicine between January 2020 and September 2020 were enrolled retrospectively. The modified Rankin Scale (mRS) score was used to evaluate the clinical outcome 3 months after the onset. ≤2 was considered as good outcome, and >2 was considered as poor outcome. The demography and baseline characteristics were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome. Results:A total of 210 patients were included, their age was 69.87±62.62 years. There were 125 males (59.52%) and 85 females (40.48%). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 4. The serum uric acid level in 169 patients (80.48%) was normal and 41 (19.52%) had hyperuricemia; 120 patients (57.14%) had a good outcome, and 90 (42.86%) had a poor outcome. Blood glucose level, serum uric acid level, baseline NIHSS score and the proportions of diabetes mellitus, history of stroke or transient ischemic attack, hyperuricemia in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [ OR] 2.735, 95% confidence interval [ CI] 1.461-5.121; P=0.002), hyperuricemia ( OR 2.400, 95% CI 1.102-5.228; P=0.027), and higher baseline NIHSS score ( OR 1.233, 95% CI 1.118-1.360; P<0.001) were the independent risk factors for poor outcome in patient with acute ischemic stroke. Conclusion:Hyperuricemia is an independent risk factor for poor outcome in patients with acute ischemic stroke.

Clinical study of electroacupuncture and Shenmai injection combined with conventional western therapy as treatments for the sudden deafness / 国际中医中药杂志

Objective To observe the clinical effect of electroacupuncture and Shenmai injection combined with conventional western therapy as treatments for the sudden deafness.Methods A total of 186 patients with sudden deafness were randomly divided into two groups. Each group included 93 patients. The control group was treated with the pipe-expanding and anti-inflammatory, but the treatment group was treated with electroacupuncture and Shenmai injection based on the control group. Both groups were treated for 11 days.Before and after treatments, the regional cerebral blood flow (rCBF) was detected. The MADSEN was used to detect ocular vestibular evoked myogenic potential (oVEMP), including N1-Pl amplitude, N 1-Pl incubation period, N1-Pl wave duration and extraction rate of oVEMP.Results The recovery rate of control group was 63.4% (59/93) and total effective rate was 90.3% (84/93), which was 88.6% (75/93) and 97.8% (91/93) in combined treatment group, and there was significant difference between the 2 groups (χ2=5.923,P<0.05). After 11 days of treatment, the Tinnitus (17.2%vs. 30.1%,χ2=7.152), vertigo and survival rate (15.1%vs. 21.5%, χ2=6.023) in combined treatment group showed significantly lower than those in the control group (P<0.05). The threshold (39.59 ± 5.36 dBHLvs. 45.85 ± 5.08 dBHL,t=2.903) in combined treatment group showed significantly lower than those in the control group (P=0.034). The N1 amplitude (10.62 ± 0.84μVvs. 7.14 ± 0.59μV;t=3.259,P=0.017), P1 amplitude (11.79 ± 0.91μVvs. 9.90 ± 0.82μV;t=2.871,P=0.037), extraction rate of oVEMP (95.7%vs. 81.7%;χ2=7.963,P=0.012) in combined treatment group showed significantly higher than those in the control group. The N1 incubation period (7.86 ± 0.82 msvs. 9.78 ± 1.24 ms;t=3.729,P=0.009) and Pl incubation period (6.57 ± 0.77 msvs. 9.39 ± 1.15 ms;t=3.064,P=0.025) in combined treatment group showed significantly lower than those in the control group.Conclusions The Electroacupuncture and Shenmai injection combined with conventional western therapy could improve blood circulation produce a synergistic therapeutic effect on damaged tissue, improve cochlear hair cells and vestibular nerve regeneration, and repaire the functions.

Taxane-cisplatin-fluorouracil as induction chemotherapy for advanced head and neck cancer: a Meta-analysis of the efficacy and safety / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To systematically review the efficacy and safety of taxane, cisplatin, and fluorouracil (Tax-PF) as induction chemotherapy for advanced head and neck cancer.@*METHOD@#Literature about the efficacy and safety of Taxane-cisplatin-fluorouracil as induction chemotherapy for advanced head and neck cancer was retrieved from digital databases of PubMed, Embase, SpringerLink, MEDLINE and the Cochrane Library before February 2015. Data extraction and quality assessment of included studies were conducted by two reviewers independently. Stata 13.0 was then used to perform Meta-analysis.@*RESULT@#A total 7 randomized controlled trials involving 2,702 were included. The 3-year OS rate [HR = 1.14, 95% CI (1.03, 1.25), P < 0.01], 3-year PFS rate [HR = 1.24, 95% CI (1.08, 1.43), P < 0.01], 5-year OS rate [HR = 1.30, 95% CI (1.09, 1. 55), P < 0. 01], 5-year PFS rate [HR = 1.39, 95% CI (1.14, 1.70), P < 0.01] and ORR to chemotherapy [OR = 1.66, 95% CI (1.35, 2.05), P < 0.01] of the patients in the Tax-PF group were statistically superior to those in the PF group. In terms of toxicities, the incidence of febrile neutropenia [OR = 2.36, 95% CI (1.62, 3.46), P < 0.01], alopecia [OR = 8.22, 95% CI (3.99, 16.92), P < 0.01], diarrhea [OR = 1.57, 95% CI (1.05, 2.36), P< 0.05] and leucopenia [OR = 2.79, 95% CI (1.86, 4.21), P < 0.01] was higher in the Tax-PF group than that in the PF group.@*CONCLUSION@#The Tax-PF induction chemotherapy improved PFS and OS, and the ORR was better as compared to PF-based therapy regimens at the cost of a higher incidence of adverse events.

Analysis on allergen of clinical allergic rhinitis patients in north-west mountain area of Hubei Province / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the main inhaled allergens and the difference of that between city and rural suburbs in patients with allergic rhinitis in the mountain region of the northwest Hubei province and to provide epidemiological basis for prevention and treatment in the region.@*METHOD@#Eight hundred and thirty-five cases who were diagnosed as allergic rhinitis with standardized allergens in Taihe Hospital of Hubei University of Medicine from Sep 2009 and Dec 2011 were studied. The data of allergens and the distribution of the patients were recorded and analyzed. χ2-test were used to analyze the data.@*RESULT@#The top 7 of inhaled allergens were house dust mites (89.6%), dust mites (86.0%), tropical mites (56.9%), croton bug (18.8%), felon herb (8.1%), the cat hair (8.1%) and fine chain alternata bacteria (9.5%), Two main kinds of allergen in three different area are with no obvious difference (P > 0.05).@*CONCLUSION@#In northwest Hubei Province, the highest rate of inhaled allergens was dust mites, which are approximate in different age groups and different regions, especially in the city.

The clinical curative effect of the low temperature plasma ablation adenoidectomy and tympanic membrane indwelling catheter in parallel or not used on childhood patients with secretory otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the clinical effect of endoscope-guided low temperature plasma ablateing adenoidectomy with tympanic membrane incision drainage and tympanic membrane indwelling catheter to treat secretory otitis media of children.@*METHOD@#Fifty-two cases (98 ears) of secretory otitis media in children with adenoid hypertrophy were treated. Respectively endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy and endoscope-guided tympanic membrane indwelling catheter parallel low temperature plasma ablateing adenoidectomy.@*RESULT@#In group A, 30 cases of 58 ears, cure 36 ears, improving 14 ears, invalid 8 ears, the effective rate was 86.2%. In group B, 22 cases of 40 ears, cured 32 ears, improvement in 6 ears, invalid 2 ears, the effective rate was 95.0%. According to statistical analysis of curative effect, there was no significant difference by effective rate between two groups.@*CONCLUSION@#For the patients with secretory otitis media caused by adenoidal hypertrophy, the endoscope-guided tympanic membrane incision drainage parallel low temperature plasma ablateing adenoidectomy can be regarded as a kind of method to reduce the risk of tympanic membrane perforation.

Pingyangmycin Local Injection Under Suspension Microlaryngoscopy for Hemangioma at Laryngopharyngeal and Laryngeal in 22 Cases / 医药导报

Objective To study the therapeutic effect of pingyangmycin local injection under suspension microlaryngoscopy for treatment of laryngopharyngeal and laryngeal hemangioma. Methods The total of 44 cases of patients with laryngopharyngeal or laryngeal hemangioma were randomly divided into the experimental group ( n=22 ) and the control group (n=22). They were treated with bleomycin 5 mg or pingyangmycin 4-8 mg injection under suspension microlaryngoscopy in the hemangioma, respectively. If the treatments were not curative, repeated one more times in intermittent 15 d, but not more than 3 times. Therapeutic effect and adverse effect were recorded and analyzed. Results The total effective rate (95. 4%)in the experimental group was significantly better than that (59. 1%) in the control group (P<0. 05),and side reaction in two groups showed no significant variation. Conclusion Pingyangmycin local injection for treating laryngopharyngeal and laryngeal hemangioma is effective, less adverse reaction.

Primary myoepithelial carcinoma of the preauricular area in a young female: a rare case report / 临床耳鼻咽喉头颈外科杂志

A female patient with a dark red mass in the of preauricular area for over 3 months was hospitalized. Enhanced CT scan and ultrasonography showed that the mass had clear boundaries and was rich in blood supply. The patient was misdiagnosed as preauricular hemangioma, then the mass was removed as a benign tumor and found irrelevant to parot, SMA(+), Vim(+), S-100(+), indicating myoepithelial carcinoma. So a radical excision was performed to get negative incised margin. The patient didn't undergo postoperative chemotherapy but demonstrated no evidence of recurrence over a 12-month follow-up.

Meta-analysis of association between MMP-1-1607 polymorphism and head and neck cancer risk in asia population / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze and explore the association between the 1607(1G/2G) single nucleotide polymorphism (SNP) in promoter of matrix metalloproteinase-1 (MMP-1) gene and susceptibility of head and neck cancer (HNC) by Meta-analysis.@*METHOD@#By the end of January 2014, the published literatures were collected for the case-control studies evaluating the relationship between HNC and -1607 SNP of MMP-1 gene from English and Chinese literature databases according to the inclusion and exclusion criteria. Then the meta-analysis, the heterogeneity, bias and sensitivity of the results of the eligible literatures were conducted by Stata 10. 0.@*RESULT@#A total of 9 studies including 2049 patients with HNC and 2158 controls were extracted for systematic review on the association of MMP-1 (-1607) 1G/2G SNP with the risk of HNC. Meta-analysis which based on random effects model showed that MMP-1 (-1607) 1G/2G SNP can significantly increase the risk of HNC[1G2G + 2G2G vs. 1G1G: OR = 1.45, 95% CI 1.25-1.68, P < 0.01; 2G2G vs. 1G1G + 1G2G:OR = 1.77, 95% CI 1.37-2.30, P < 0.01; 2G vs. 1G: OR = 1.52, 95% CI 1.26-1.85, P < 0.01; 2G2G vs. 1G1G: OR = 2.06, 95% CI 1.41-3.01, P < 0.01).@*CONCLUSION@#MMP-1 (-1607) 1G/2G SNP has close relationship with HNC susceptibility, people who with 2G2G genotype carriers are susceptible to HNC.

Establishing a tube foam scaffold for tracheal cartilage tissue engineering by using solvent casting/particulate leaching method / 中国组织工程研究

BACKGROUND: Both aperture and porosity are mainly evaluating markers for three-dimensional poly materials. The higher the porosity is, the easier the growth and proliferation of cartilage cells are. However, with the successive increasing of porosity, compressive strength of scaffolds decreases and utility of aperture also decreases. Therefore, it is extremely significant for tracheal cartilage tissue engineering to establish three-dimensional poly scaffolds which have suitable aperture and porosity.OBJECTIVE: To establish tube foam scaffolds by using solvent casting/particulate leaching method so as to find out practical and ideal scaffolds for tracheal cartilage tissue engineering.DESIGN: Observational study.SETTING: Department of Otolaryngology, Taihe Hospital, Yunyang Medical College; Department of Otolaryngology, West China Hospital, Sichuan University.MATERIALS: The experiment was carried out in Chemical Institute, Chengdu Sub-college of Chinese Academy of Sciences from March to May 2002. Poly-D, L-lactic acid (PDLLA, Mr= 4.23×104) and sodium chloride granules (50-200 μm in diameter) were used as porogenic agent.METHODS: PDLLA was dissolved in chloroform in spherical-shape glass container to dispend 100 g/L solution and then add with sodium chloride granules (50-200 μm) based on various mass fractions of 800, 850, 900, 920, 940 and 960 g/L. Sodium chloride granules were regarded as porogenic agent (scaffolds numbered from 1 to 6) to stir and make paste suspension. Continuously, suspension was cast into tube models, heated at 90 ℃, compressed,and maintained in ventilation cabinet for 48 hours for solvent volatilization. And the resting solvent was drawn out.Form-fitting drying tube foam scaffolds were taken out and dipped in double distilled water for 48 hours so as to remove sodium chloride. The double distilled water was changed every 8 hours. Then, all tube materials were dried in vacuum drying oven for 24-48 hours. While, three-dimensional PDLLA scaffolds were successfully established.Form and intensity of scaffolds were observed with gross and scanning electron microscope; meanwhile, pore parameter was measured and analyzed.MAIN OUTCOME MEASURES: ①Gross observation of tube foam scaffolds;② measurement of pore parameters.RESULTS: ①Scaffolds were appeared as white tube foam with 8 mm in internal diameter and 12 mm in outside diameter.Scaffolds with 80-250 μm in bore and 90.6% in porosity had defined strength and ductility. ②Scanning electron microscope demonstrated that there were many holes distributed in PDLLA scaffolds in various sizes. Otherwise, hole of scaffolds was connected to each other, while big hole also contained numerous small holes. ③Porosity of scaffolds increased with the increasing mass fraction of sodium chloride; but effective porosity did not increase with the increasing mass fraction of sodium chloride. There were different effective porosities of bore (80-250 μm). Effective bore of number 4 sample was 76% and relative porosity was 90.6%. Therefore, number 4 sample was an ideal scaffold for tracheal cartilage tissue engineering.CONCLUSION: Tube foam scaffold fabricated by solvent casting/particulate leaching method is suitable for tracheal cartilage tissue engineering.