Discussion on the Medication Rules of ZHONG Guang-Ling in Treating Lumbar Disc Herniation / 广州中医药大学学报

Objective To explore the medication rules of Professor ZHONG Guang-Ling's prescriptions for the treatment of lumbar disc herniation(LDH)based on data mining method,so as to provide reference for the treatment of LDH with Chinese medicine.Methods The prescriptions for the effective cases of outpatients of LDH treated by Professor ZHONG Guang-Ling in the recent 5 years were collected.The medication frequency of Chinese medicines in the included prescriptions and the distribution of their properties,flavors and meridian tropism were investigated.Moreover,the association rule analysis and cluster analysis of the high-frequency drugs were carried out.Results A total of 164 prescriptions were included and 168 Chinese medicines were used.The top 10 high-frequency drugs in descending order were Achyranthis Bidentatae Radix,Chuanxiong Rhizoma,Pheretima,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Gentianae Macrophyllae Radix,Angelicae Sinensis Radix,Rehmanniae Radix Praeparata,Persicae Semen,Cyperi Rhizoma,and Carthami Flos.The properties of the prescribed drug were mainly warm and mild in nature,and bitter and pungent in flavor,and mainly had the meridian tropism of the liver,kidney and spleen meridians.According to the therapeutic actions,the drugs were mainly categorized as deficiency-supplementing drugs,dampness-removing and collateral-unblocking drugs,and blood-activating and stasis-removing drugs.The results of association rule analysis yielded 10 drug pairs,and cluster analysis yielded 6 core drug combinations.Conclusion For the treatment of LDH,Professor ZHONG Guang-Ling usually adopts the Chinese medicine for supplementing the deficiency and supporting healthy-qi,together with the medicines for nourishing the liver and kidney and regulating the spleen and stomach from the perspective of liver,kidney and spleen.Moreover,therapy of activating blood and removing stasis is also stressed,pathogen-eliminating medicines for removing dampness,unblocking collaterals and clearing heat are used based on syndrome differentiation,and then simultaneous application of purging and nourishing therapeutics is achieved through the utilization of purging method after supplementing method.

The feasibility and safety of simultaneous bilateral adrenal vein sampling using 4F-MPA1 catheter via right elbow vein access:preliminary results in 51 patients / 介入放射学杂志

Objective To discuss the feasibility and safety of simultaneous bilateral adrenal vein sampling(AVS)using two 4F-MPA1 catheters via right elbow vein access.Methods A total of 51 consecutive patients with primary aldosteronism,who received simultaneous bilateral AVS using two 4F-MPA1 catheters(one of the two catheters was shaped into pig tail figure)via right elbow vein access at Xiangyang Municipal Central Hospital between October 2021 and October 2022,were enrolled in this study.The used catheter,the success rate of simultaneous bilateral AVS,and the incidence of complications rate were calculated.Results The 4F-MPA1 catheter was used for all of the right AVS,while a specially shaped 4F-MPA1 catheter was used for the main trunk vein AVS of the left adrenal gland and the central vein AVS of the left adrenal gland.The success rate of simultaneous bilateral AVS was 92.2%(47/51).Adrenal hematoma occurred in one patient(1.96%).Conclusion The technique of simultaneous bilateral AVS using two 4F-MPA1 catheters via right elbow vein access is simple to operate,less traumatic,and clinically safe and feasible.However,due to the small sample used in this study,the clinical value of this technique still needs further investigation and verification.

Efficacy comparison of simultaneous and staged video-assisted thoracoscopic surgery anatomic segmentectomy for bilateral double primary lung cancer / 肿瘤研究与临床

Objective:To explore the clinical efficacy of simultaneous or staged video-assisted thoracoscopic surgery (VATS) anatomic segmentectomy for bilateral double primary lung cancer (DPLC).Methods:A retrospective cohort study was conducted. The clinical data of 76 patients with bilateral DPLC who underwent VATS anatomic segmentectomy in Luzhou Traditional Chinese Medicine Hospital from February 2020 to August 2022 were retrospectively analyzed, and they were classified into the simultaneous bilateral thoracoscopic surgery group (the simultaneous group, 44 cases) and the staged thoracoscopic surgery group (the staged group, 32 cases) on the basis of the surgical methods. The intraoperative conditions, perioperative indexes and postoperative complications of the two groups were compared.Results:There were no statistically significant differences in the gender, age, pathological type,postoperative TNM staging of both groups (all P > 0.05). The anesthesia awakening time of the first and second stages of surgery in the staged group was (11±3) min and (13±4) min, which was shorter than that in the simultaneous group [(16±4) min] ( t values were 5.27 and 3.51, both P < 0.05). The number of drainage tubes placed in the simultaneous group was less than that in the sum of two stages of the staged group [(1.9±0.5) tubes vs. (2.2±0.5) tubes, t = 3.40, P = 0.001]. The duration of thoracic drainage tube retention, the postoperative total drainage flow, the days of hospitalization, the first postoperative landing time, and the total treatment cost in the first and second stages of surgery in the staged group were lower than those in the simultaneous group (all P < 0.05), while the postoperative total drainage flow, the days of hospitalization, and the total treatment cost in the sum of two stages of the staged group were higher than those in the simultaneous group (all P < 0.05). The total incidence of complications in the simultaneous group was higher than that in the staged group 1 month after surgery [18.18% (8/44) vs. 3.13% (1/32)], and the difference was statistically significant ( χ2 = 4.02, P = 0.045). The scores of activities of daily living, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, and blood oxygen saturation in the simultaneous group were lower than those in the staged group (all P < 0.05). Conclusions:Staged VATS anatomic segmentectomy for bilateral DPLC has few complications and good ability to perform activities of daily living, whereas the treatment cost of simultaneous bilateral thoracoscopic surgery is low. Clinicians may recommend prioritizing simultaneous bilateral thoracoscopic surgery after comprehensively considering the patients ' physical and economic conditions.

Item Screening of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome Based on Delphi Method / 中国中医药信息杂志

Objective To screen items of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome;To provide reference for the formulation and improvement of the scheme.Methods The Delphi method was used to distribute two rounds of questionnaires to 60 experts in cerebropathy or neurology across the country.Statistical analysis was performed on the questionnaire results of the scheme's items,including the disease names,etiology and pathogenesis,syndrome characteristics,rules and regulations,representative prescriptions,acupuncture and other therapies,and preventive care.Results Totally 42 and 50 valid questionnaires were collected.The experts reached the consensus for the importance of etiology and pathogenesis,rules and regulations,acupuncture and other therapies,and preventive care.In the section on syndrome characteristics,items with low relevance or causing ambiguity were removed.Items that were no longer used in modern times and different prescriptions with the same name were removed from the representative prescriptions.The names of syndromes,rules and regulations were unified.Conclusion The experts generally reached the consensus for the importance of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome.However,there are still some limitations that require further study and discussion.

Simultaneous Determination of 9 Components in Shujin Tongluo Black Plaster by HPLC / 中国中医药信息杂志

Objective To establish an HPLC-based method for the determination of α-obscurine,ferulic acid,hydroxysafflower yellow A,benzoylneaconitine,benzoylaconitine,periplosin,4-methoxysalicylsalicylate,kaempferol and oleanolic acid simultaneously in Shujin Tongluo Black Plaster.Methods HPLC method was used to determine the 9 components in Shujin Tongluo Black Plaster simultaneously.The 70%methanol extracts were analyzed using Waters SunFire C18 chromatography column(4.6 mm×250 mm,5 μm),in mobile phase containing acetonitrile-0.2%phosphoric acid solution for gradient elution with volume flow rate of 1.0 mL/min;column temperature was set at 25℃;detection wavelength was set at 230 nm.Results The 9 components had good linear relationship in their respective ranges(r≥0.999 7).The average recoveries were between 98.06%-100.56%and RSD was between 0.48%-2.56%,respectively.Conclusion The method has the advantage of repeatability,simple and fast,and can be used as the quality control of Shujin Tongluo Black Plaster.

The efficacy of simultaneous single shot-echo planar imaging and readout segment of long variable echo trains sequences diffusion-weighted imaging for diagnosis of malignant breast lesions / 中华放射学杂志

Objective:To compare the image quality and the diagnostic efficiency for breast malignant lesions using simultaneous multi-slice single shot echo planar imaging (SMS+SS-EPI) and readout segment of long variable echo trains (RESOLVE) for breast diffusion-weighted imaging (DWI).Methods:This study was a cross-sectional study. Clinical and imaging data of 102 patients with breast lesion from March 2021 to February 2023 in the First Hospital Affiliated to Ningbo University were prospectively analyzed. All patients underwent routine breast MRI scans and cross-sectional RESOLVE and SMS+SS EPI sequence DWI, and the image quality of 2 types sequences of DWI was evaluated. The subjective evaluation was based on a 5-point scale, including geometric distortion, artifact blurring, fat suppression, overall image quality, and lesion conspicuity of the breast. The objective evaluation included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) value of the lesion. Wilcoxon signed rank sum test was used to compare the subjective and objective parameters between the two sequences. Finally, the receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the effectiveness of ADC values for diagnosing breast malignant lesions based on two sequence images.Results:All 102 female patients had single lesions, aged from 25 to 68 years and 60 lesions were malignant and 42 were benign. The acquisition time for SMS+SS-EPI sequence imaging was 1 min 50 s, and the acquisition time for RESOLVE sequence imaging was 3 min 43 s.The subjective scores from both SMS+SS-EPI and RESOLVE sequence were over than 3 points. The geometric distortion, artifact blurring, and overall image quality scores of RESOLVE sequence images were higher than those of SMS+SS-EPI (all P<0.001). The overall lesion conspicuity score, malignant lesion conspicuity score, and benign lesion conspicuity score of DWI and ADC images combined with SMS+SS-EPI sequence were higher than those of the RESOLVE sequence (all P<0.05). There were no statistically difference in SNR, CNR, overall ADC value, malignant ADC value, and benign ADC value between SMS+SS-EPI and RESOLVE sequence DWI images of breast lesions (all P>0.05). The AUC of RESOLVE sequence ADC value in diagnosis of breast cancer was 0.973, the sensitivity was 0.929, and the specificity was 0.915; The AUC of SMS+SSC-EPI sequence ADC value in diagnosis of breast cancer was 0.956, the sensitivity was 0.977, and the specificity was 0.850. Conclusions:In breast DWI, the subjective score of SMS+SS EPI image quality can basically meet the diagnostic requirements and the conspicuity of lesions is better than that of the RESOLVE sequence. Both have good diagnostic efficacy for malignant breast lesions.

A novel two-surgeon technique of simultaneous bilateral cataract surgery with complete delinking

Though technological advancements have transcended beyond expectation, phacoemulsification remains a challenge in uncooperative patients, where the procedure may be contemplated under general anesthesia, with simultaneous bilateral cataract surgery (SBCS) being the surgery of choice. In this manuscript, we have reported a novel two-surgeon technique of SBCS on a 50-year-old mentally subnormal patient. Under general anesthesia, two surgeons performed phacoemulsification simultaneously, using two separate microscopes, irrigation lines, phaco machines, instruments, and assistants. Intraocular lens (IOL) implantation was performed in both eyes (OU). The patient had a visual recovery from 5/60, N36 in OU preoperatively to 6/12, N10 in OU on post-operative day 3 and 1 month, with no complications. This technique can potentially reduce the risk of endophthalmitis, repeated and prolonged anesthesia, and the number of hospital visits. To the best of our knowledge, this two-surgeon technique of SBCS has never been reported in the literature.

Calidad visual y de vida en la cirugía refractiva bilateral simultánea del cristalino en pacientes hipermétropes / Visual quality and quality of life in simultaneous bilateral refractive lens surgery in hyperopic patients

Introducción: La cirugía actual de la catarata no comprende solo restablecer la visión en su mayor cantidad posible, sino que incluye además la psicofísica de la visión. Objetivo: Evaluar los resultados de la cantidad, calidad visual y de vida en la cirugía refractiva bilateral simultánea del cristalino en pacientes hipermétropes. Métodos: Se realizó un estudio descriptivo longitudinal prospectivo de serie de casos en 108 ojos de 54 pacientes con catarata bilateral e hipermetropía operados por cirugía bilateral simultánea en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" desde noviembre 2018 hasta abril 2022. Se emplearon los porcentajes y los números absolutos para resumir las variables cualitativas. En el caso de las cuantitativas se usó la media con su desviación estándar (DE) y el intervalo de confianza del 95 por ciento. Resultados: Fue más frecuente el sexo femenino con una edad media de 69,1 ± 8,1 años. El 55,11 por ciento de los pacientes tuvo dureza NO3. La agudeza visual monocular mejoró en el 97,2 por ciento y el 100 por ciento la mejoró de forma bilateral. Hubo una pérdida celular endotelial de 10,19 por ciento. La visión de colores y la sensibilidad al contraste mostraron de igual manera mejoría significativa. Conclusiones: La cirugía bilateral simultánea del cristalino en pacientes hipermétropes contribuye de manera significativa a la mejoría de la visión en cantidad y calidad, por lo que permite recuperar la calidad de vida(AU)

Introduction: Current cataract surgery does not comprise only restoring vision to its greatest possible quantity, but also includes the psychophysics of vision. Objective: To evaluate the results of quantity, visual quality and quality of life in simultaneous bilateral refractive surgery of the crystalline lens in hyperopic patients. Methods: A prospective longitudinal descriptive case series prospective study was performed in 108 eyes of 54 patients with bilateral cataract and hyperopia operated by simultaneous bilateral surgery at the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" from November 2018 to April 2022. Quality of life was also taken into account by the FV-14 survey. Percentages and absolute numbers were used to summarize the qualitative variables. In the case of quantitative variables, the mean with standard deviation (SD) and 95 percent confidence interval were used. Results: The female gender was more frequent with an average age of 69.1±8.1 years. 55.11 percent of patients had NO3 hardness. Monocular visual acuity improved in 97.2 percent and 100 percent improved bilaterally. There was an endothelial cell loss of 10.19 percent. Color vision and contrast sensitivity likewise showed significant improvement. Conclusions: Simultaneous bilateral lens surgery in hyperopic patients, contributes significantly to the improvement of vision in quantity and quality, thus allowing recovery of quality of life(AU)

Agujero macular idiopático bilateral simultáneo con cierre espontáneo de un lado / Simultaneous bilateral idiopathic macular hole with spontaneous one-sided closure

Introducción: El agujero macular idiopático se caracteriza como la pérdida central de la agudeza visual. La presentación bilateral se presenta con una frecuencia desde el 4,8 hasta el 30 por ciento y el cierre espontáneo para diámetros menores a 250 um es de 3,5 por ciento. Objetivo: Describir las formas de presentación y tratamientos alternativos en pacientes con agujero macular idiopático. Presentación de caso: Paciente mujer de 66 años sin antecedentes médicos que presenta un agujero macular idiopático bilateral y simultáneo. En el examen de tomografía de coherencia óptica del ojo derecho presentó 190 um y del ojo izquierdo 210 um. En el ojo izquierdo se le realizó intervención quirúrgica y en el ojo derecho presentó un cierre espontáneo con evolución favorable anatómica y funcional. Conclusiones: Los agujeros maculares idiopáticos se pueden presentar de manera bilateral. Las opciones terapéuticas y el manejo quirúrgico son algunas de las alternativas para su atención(AU)

Introduction: Idiopathic macular hole is characterized as central loss of visual acuity. Bilateral presentation occurs with a frequency from 4.8 percent to 30 percent and spontaneous closure for diameters less than 250 um is 3.5 percent. Objective: To describe the forms of presentation and alternative treatments in patients with idiopathic macular hole. Case presentation: We present a case of a 66-year-old female patient with no medical history presenting with a simultaneous bilateral idiopathic macular hole. Optical coherence tomography examination of the right eye showed 190 um and of the left eye 210 um. In the left eye she underwent surgical intervention and in the right eye she presented spontaneous closure with favorable anatomical and functional evolution. Conclusions: Idiopathic macular holes can present bilaterally and therapeutic options and surgical management are some of the alternatives for their care(AU)

Effectiveness of influenza and pneumococcal vaccines in patients with diabetes / 中国生物制品学杂志

@#Authoritative guidelines and consensus domestic and overseas suggest that patients with diabetes get influenza vaccine and pneumococcal vaccine,which can significantly reduce the incidence and hospitalization rate of influenza and pneumococcal diseases in diabetic patients,and can also reduce the risk of cardiovascular events and mortality.The protective effect of simultaneous administration is more significant.At present,the vaccination rate of influenza and pneumococcal vaccines for diabetic patients is still low in China.Effective measures should be taken to promote the integration of medical treatment and prevention,strengthen knowledge popularization and guide publicity,and improve the vaccination rate,so as to effectively improve the survival status and prognosis of diabetic patients.This paper compre-hensively reviews the research progress on the effectiveness of influenza and pneumococcal vaccines in diabetic patients at home and abroad in recent years.

Denitrifying phosphate accumulating organisms and its mechanism of nitrogen and phosphorus removal / 生物工程学报

Water eutrophication poses great threats to protection of water environment. Microbial remediation of water eutrophication has shown high efficiency, low consumption and no secondary pollution, thus becoming an important approach for ecological remediation. In recent years, researches on denitrifying phosphate accumulating organisms and their application in wastewater treatment processes have received increasing attention. Different from the traditional nitrogen and phosphorus removal process conducted by denitrifying bacteria and phosphate accumulating organisms, the denitrifying phosphate accumulating organisms can simultaneously remove nitrogen and phosphorus under alternated anaerobic and anoxic/aerobic conditions. It is worth noting that microorganisms capable of simultaneously removing nitrogen and phosphorus absolutely under aerobic conditions have been reported in recent years, but the mechanisms remain unclear. This review summarizes the species and characteristics of denitrifying phosphate accumulating organisms and the microorganisms capable of performing simultaneous nitrification-denitrification and phosphorous removal. Moreover, this review analyzes the relationship between nitrogen removal and phosphorus removal and the underlying mechanisms, discusses the challenges of denitrifying phosphorus removal, and prospects future research directions, with the aim to facilitate process improvement of denitrifying phosphate accumulating organisms.

Research advances in mechanism of lipid infiltration of coronary heart disease and simultaneous treatment of phlegm and blood stasis based on phlegm-blood stasis correlation theory / 中国中药杂志

Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of AS. The theory highlights that the occurrence and development of AS are closely related to abnormal lipid metabolism, with the essence of the pathological reaction caused by the invasion of lipids into arterial intima from plasma. Phlegm and blood stasis are physiologically homologous and subject to pathological co-existence. Phlegm-blood stasis correlation is the basic theory to explain the pathogenesis characteristics of CHD and has important guiding significance for revealing the mecha-nism of lipid infiltration of CHD. Phlegm is the pathological product of abnormal metabolism of Qi, blood, and body fluid, and a gene-ral summary of a series of abnormally expressed lipid substances. Among them, turbid phlegm invades the heart vessels, gradually accumulates, and condenses to achieve the qualitative change from "invisible pathogen" to "tangible pathogen", which corresponds to the mechanism of lipid migration and deposition in the intima of blood vessels, and is the starting factor of the disease. Blood stasis is the continuous development of phlegm, and it is a result of pathological states such as decreased blood fluidity, increased blood coagulation, and abnormal rheology. The fact that blood stasis caused by phlegm accords with the pathological process of "lipid abnormality-circulatory disturbance" and is the central link of the disease. Phlegm and blood stasis aggravate each other and lead to indissoluble cementation. The phlegm-blood stasis combination serves as common pathogen to trigger the disease, which is the inevitable outcome of the disease. Based on the phlegm-blood stasis correlation theory, the simultaneous treatment of phlegm and blood stasis is established. It is found that this therapy can simultaneously regulate blood lipid, reduce blood viscosity, and improve blood circulation, which can fundamentally cut off the biological material basis of the reciprocal transformation between phlegm and blood stasis, thus exerting a significant curative effect.

Preclinical Image Quality Evaluation of Simultaneous Vision Intraocular Lenses / 中国医疗器械杂志

Three different preclinical evaluation methods of MTF through-frequency response, MTF through-focus-response and expected visual acuity were used to compare and analyze the imaging differences of IOLs with four different optical designs. The research work could be used in the simultaneous vision IOLs in the optical design stage and verify the optical quality of the IOLs, the results can predict the visual representation of the patients better. The evaluation results can provide reference for IOL manufacturers and users in product design, development, validation and application selection.

Quality of moxa from Artemisia argyi and A. stolonifera in different storage years based on simultaneous thermal analysis / 中国中药杂志

The quality of moxa is an important factor affecting moxibustion therapy, and traditionally, 3-year moxa is considered optimal, although scientific data are lacking. This study focused on 1-year and 3-year moxa from Artemisia stolonifera and A. argyi(leaf-to-moxa ratio of 10∶1) as research objects. Scanning electron microscopy(SEM), Van Soest method, and simultaneous thermal analysis were used to investigate the differences in the combustion heat quality of 1-year and 3-year moxa and their influencing factors. The results showed that the combustion of A. stolonifera moxa exhibited a balanced heat release pattern. The 3-year moxa released a concentrated heat of 9 998.84 mJ·mg~(-1)(accounting for 54% of the total heat release) in the temperature range of 140-302 ℃, with a heat production efficiency of 122 mW·mg~(-1). It further released 7 512.51 mJ·mg~(-1)(accounting for 41% of the total heat release) in the temperature range of 302-519 ℃. The combustion of A. argyi moxa showed a rapid heat release pattern. The 3-year moxa released a heat of 16 695.28 mJ·mg~(-1)(accounting for 70% of the total heat release) in the temperature range of 140-311 ℃, with an instantaneous power output of 218 mW·mg~(-1). It further released 5 996.95 mJ·mg~(-1)(accounting for 25% of the total heat release) in the temperature range of 311-483 ℃. Combustion parameters such as-R_p,-R_v, D_i, C, and D_b indicated that the combustion heat quality of 3-year moxa was superior to that of 1-year moxa. It exhibited greater combustion heat, heat production efficiency, flammability, mild and sustained burning, and higher instantaneous combustion efficiency. This study utilized scientific data to demonstrate that A. stolonifera could be used as excellent moxa, and the quality of 3-year moxa surpassed that of 1-year moxa. The research results provide a scientific basis for the in-depth development of A. stolonifera moxa and the improvement of moxa quality standards.

Coronary Heart Disease and Obstructive Sleep Apnea Syndrome： Interpretation and Reflection Based on Simultaneous Treatment of Heart and Lung in Traditional Chinese Medicine / 中国实验方剂学杂志

As the overweight and obese population is growing， the incidence of obstructive sleep apnea is rising， and most of the cases are complicated with coronary heart disease and other cardiovascular diseases. The two diseases affect each other and seriously endanger the patients' health， becoming a major public health problem of global concern. It is of great clinical importance to explore the combination of Chinese and Western medicine in the prevention and treatment of coronary heart disease complicated with obstructive sleep apnea syndrome. Researchers have explored the relationship between the two based on traditional Chinese medicine（TCM） theory and found that the two diseases belong to the TCM disease categories of chest impediment and snoring， respectively， and their co-morbidity is associated with the abnormal physiological functions of the heart and lungs. The failure of the heart to govern blood leads to the generation of blood stasis， and that of the lung to govern Qi movement leads to the generation of phlegm. The accumulation of phlegm and blood stasis in the chest causes chest impediment and snoring due to obstruction of the airway. This paper discusses the internal linkage between the pathogenesis of coronary heart disease and obstructive sleep apnea syndrome in Chinese and Western medicine from the TCM theory of heart-lung correlation. Furthermore， this paper proposes the treatment principles of simultaneously treating the heart and lung and activating blood and resolving phlegm， aiming to provide a theoretical basis for the clinical prevention and treatment of coronary heart disease complicated with obstructive sleep apnea.

An analysis on the compatibility principle and efficacy characteristics of Wumei Pill from the perspective of "Tang-Ye-Jing-Fa Map" / 国际中医中药杂志

Wumei Pill is a classic insect repellent prescription, which is used for ascaris lumbricoides and diarrhea. It is considered to be a representative prescription for the treatment of simultaneous occurrence of cold and heat syndromes. Its prescription is mainly composed of sour drugs ( Mume Fructus and bitter wine) and pungent drugs ( Aconiti Lateralis Radix Praeparataaconite, Cinnamomi Ramulus, Sichuan pepper, Angelicae Sinensis Radix, Zingiberis Rhizoma, and Asari Radix et Rhizoma), supplemented by bitter drugs ( Coptidis Rhizoma and Phellodendri Chinensis Cortex) and sweet drugs ( Ginseng Radix et Rhizoma and honey). From the point of view of "Tang-Ye-Jing-Fa Map", the role of liver is to disperse, whose deficiency leads to limb syncope, and excess leads to the full of hypochondrium and abdominal pain. The pungent herbs can tonify the liver-deficiency, the sour herbs can dispel the liver-excess, and sweet herbs can relive them both. The role of spleen is to moderate, whose deficiency leads to fatigue and weakness, and excess leads to the vomiting and diarrhea. The sweet herbs can tonify the spleen-deficiency, the pungent herbs can dispel the spleen-excess, and bitter herbs can relive them both. Therefore, the function of Wumei Pills is located in the liver and spleen, giving consideration to the heart and lung. It is used for the deficiency and excess mixed syndrome of liver and spleen, which is mainly characterized by chest and flank abdominal pain, limb chills, diarrhea, muscle and pulse contracture and the symptoms of the parts along the liver meridian. It is commonly used in the treatment of ascaris, diarrhea, impotence, depression. At the same time, it can also be used for the treatment of diseases about heart and lung, and cough, anxiety and other diseases.

Research progress on tumor treating fields combined with radiation therapy in the treatment of glioblastoma / 中华放射肿瘤学杂志

For patients with newly diagnosed glioblastoma, tumor treating fields (TTF) combined with temozolomide after radiation therapy is currently one of the standard therapeutic regimens. Recently, TTF has been increasingly applied in combination with radiation therapy since it can delay tumor DNA repair and increase DNA replication stress. The efficacy of TTF has been proven in clinical studies. However, no consensus has been reached regarding the theoretical basis, radiation dose, actual clinical operation, patients' benefit and safety, which remain controversial. In this article, research progress on these topics was reviewed.

Phase II trial of hippocampal avoidance whole-brain irradiation with simultaneous integrated boost for treatment of brain metastases of lung cancer / 中华放射肿瘤学杂志

Objective:To evaluate the efficacy and safety of hippocampal avoidance whole-brain irradiation with simultaneous integrated boost in the treatment of brain metastases of lung cancer.Methods:Forty lung cancer patients with brain metastases who received whole-brain radiotherapy with simultaneous integrated boost and hippocampal avoidance in Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2020 were enrolled in this study. Brain MRI, survival follow-up and evaluation of side effects were performed before radiotherapy and at 1, 3, 6 and 12 months after radiotherapy, respectively. Overall survival (OS), progression-free survival (PFS) and changes in cognitive function were analyzed. Continuous data were described as Mean ± SD. Categorical data were described by frequency and composition ratio or percentage. Survival analysis was conducted by Kaplan-Meier method. Influencing factors of survival were identified by univariate and multivariate Cox's regression analyses.Results:A total of 40 patients were enrolled in the study. The median follow-up time was 14.2 months and the median OS, PFS and intracranial PFS of all patients were 14.8 months, 6.7 months and 14.8 months, respectively. Multivariate analysis showed that male gender and newly diagnosed stage Ⅳ disease were associated with worse OS and PFS, respectively. The Hopkins verbal learning test-revised (HVLT-R) scores at baseline and 1, 3 and 6 months after radiotherapy were 21.94±2.99, 20.88±3.12, 20.03±3.14, and 19.78±2.98, respectively. The HVLT-R score at 6 months after radiotherapy was decreased by approximately 9.8% compared with the baseline. No grade 3 or above toxic and side effect occurred in the entire cohort.Conclusion:Hippocampal avoidance whole-brain irradiation with simultaneous integrated boost is a safe and effective treatment for brain metastases of lung cancer, which is expected to reduce the impact of radiotherapy on cognitive function.

Feasibility study of automatic uARC planning for esophageal cancer using simultaneous integrated boost radiotherapy / 中华放射肿瘤学杂志

Objective:To compare dosimetric and radiobiological parameters between automatic and manual uARC plans in the treatment of esophageal cancer patients, aiming to provide reference for clinical application.Methods:High-quality uARC plans of 100 patients with esophageal cancer were selected, and the mean values of the dosimetric parameters in the target area and organs at risk (OAR) were counted, and the goal table of uRT-TPOIS intelligent plan was established. Automatic and manual uARC plans were generated with UIH (United Imaging) treatment planning system (TPS) for 21 esophageal cancer patients. The differences in mean dose (D mean), approximate minimum (D 98%) and maximum (D 2%) dose of planning target volume (PTV), homogeneity index (HI) and conformity index (CI), dose of OAR, mean planning time, monitor unit (MU), tumor control probability (TCP) and normal tissue complication probability (NTCP) were compared between automatic and manual uARC plans. Normally distributed data between two groups were compared by paired t-test, and non-normally distributed data were assessed by nonparametric Wilcoxon test. Results:The D 98% (PTV 60 Gy: P<0.001, PTV 54 Gy: P=0.001) , CI (PTV 60 Gy: P<0.001, PTV 54 Gy: P=0.002) and target volume of area covered by prescription dose (V 54 Gy: P<0.001) of the automatic uARC plans were better than those of manual uARC plans (all P<0.05). There was no significant difference in D mean or HI between the two plans [PTV 54 Gy (59.32±1.87) Gy vs. (59.13±1.64) Gy, (0.19±0.02) vs. (0.18±0.02), all P>0.05]. The D mean and D max of spinal cord of the automatic plan were better than those of the manual plan [(13.22±4.27) Gy vs. (13.75±4.44) Gy, P=0.020 and (36.99±1.67) Gy vs. (38.14±1.31) Gy, P=0.011]. There was no significant difference in the mean dose of V 20 Gy of the lung between two plans ( P>0.05), whereas the mean doses of V 5 Gy and V 10 Gy of the lung of the manual plan were less than those of the automatic plan ( both P<0. 001). Automatic uARC plan had a significantly shorter mean planning time than manual uARC plan [(11.79±1.71) min vs. (53.36±8.23) min, P<0.001]. MU did not significantly differ between two plans [(762.84±74.83) MU vs. (767.41±80.63) MU, P>0.05]. The TCP of the automatic plan was higher than that of the manual plan (PTV 60 Gy 89.15%±0.49% vs. 86.75%±6.46%, P=0.004 and PTV 54 Gy 79.79%±3.48% vs. 77.51%±5.04%, P=0.006). However, manual plan had a lower NTCP of the lung than automatic uARC plan (0.46%±0.40% vs. 0.35%±0.32%, P<0.001). There was no significant difference in NTCP of heart and spinal cord between two plans (all P>0.05). Conclusion:It is feasible to generate automatic uARC plan with uRT-TPOIS TPS for esophageal cancer patients, which can increase the target CI and shorten the plan design time.

Efficacy analysis of simultaneous integrated boost intensity-modulated radiotherapy combined with chemotherapy in treatment of superior mediastinal lymph node metastasis after esophageal cancer surgery / 肿瘤研究与临床

Objective:To investigate the efficacy and adverse reactions of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) combined with chemotherapy in the treatment of superior mediastinal lymph node metastasis after esophageal cancer surgery.Methods:The clinical data of 72 patients with concurrent chemoradiotherapy for superior mediastinal lymph node metastasis after esophageal cancer surgery in Tai'an Cancer Prevention and Treatment Hospital from January 2019 to May 2021 were retrospectively analyzed, and they were divided into intensity-modulated radiotherapy (IMRT) group (36 cases) and SIB-IMRT group (36 cases) according to different radiotherapy methods. The short-term efficacy, long-term survival rate and adverse reactions of the two groups were compared.Results:The response rate in the IMRT group was 66.7% (24/36), the response rate in the SIB-IMRT group was 86.1% (31/36), and the difference between the two groups was statistically significant ( χ2 = 3.77, P = 0.047). The 1-, 2- and 3-year overall survival rates in the IMRT group were 75.0%, 44.4% and 27.8%, and the 1-, 2- and 3-year overall survival rates in the SIB-IMRT group were 83.3%, 52.8% and 33.3%; the difference in the overall survival between the two groups was not statistically significant ( χ2 = 0.70, P = 0.401). There were statistical differences in the incidence of leukopenia, radiation esophagitis and radiation pleural gastritis between the two groups (all P < 0.05). There were no statistical differences in the incidence of radiation pneumonia and gastrointestinal reactions between the two groups (both P > 0.05). Conclusions:SIB-IMRT combined with chemotherapy in patients with superior mediastinal lymph node metastasis after esophageal cancer surgery has good local control rate and mild adverse reactions.