[PET/CT Image Values in Clinical Staging of the Patients with Non-Hodgkin's Lymphoma].

OBJECTIVE: To explore the PET/CT image value in clinical staging for the patients with non-Hodgkin's lymphoma (NHL). METHODS: A total of 142 cases of NHL in our hospital from May 2012 to February 2015 were enrolled in this study. The results of PET/CT staging and clinical staging were compared. The staging of simple intranodal NHL and extranodal NHL with or without lymphonode involvement was analyzed. RESULTS: The clinical staging results of 142 NHL patients showed that 8 cases were observed in I stage, 34 cases were observed in II stage, 40 cases were observed in III stage, 60 cases were found in IV stage; the staging results of PET/CT showed that 6 cases were found in I stage, 36 cases were found in II stage, 44 cases were found in III stage, 56 cases were found in IV stage. The coincidence rate of PET/CT staging with clinical staging was 95.77% (136/142). Comparison of PET and CT staging for simple intranodal NHL indicated no statistical difference (P > 0.05), while the PET and CT staging results of extranodal NHL with or without lymphonode involvement were statistically significant different (P < 0.05). CONCLUSION: The PET/CT image can accurately detect the involved lymphnodes and can sensitively detect the involved extranodal lesions. PET/CT staging has high coincidence rate with clinical staging, thereby it can be used to guide the clinical treatment.

[Assessment of external methods of traditional Chinese medicine in patients with chronic ulcer of the lower extremities: study protocol of a multicenter, randomized, parallel-group, prospective trial].

BACKGROUND: Chronic ulcer of the lower extremities amounts for a grave and serious problem for public health. Western medicine focuses on controlling infection, improving blood circulation, surgical debridement, skin grafting, etc, but there are bottlenecks in the treatment. Traditional Chinese medicine (TCM) has a long history and a legacy of sound clinical efficacy in this area. TCM has developed a unique, effective external theory, and a large number of topical prescriptions and external technology. Through this research, a safe and effective treatment protocol of TCM for chronic ulcer of the lower extremities can be formed. To this end, during China's "Eleventh Five-Year" Plan, special research committees and projects on TCM external treatments and external technologies were established. This study on ulcer of the lower extremities constitutes one of the major research topics. METHODS AND DESIGN: Clinical information of patients with chronic ulcer of the lower extremities will be first collected in a large, multicenter, epidemiological survey. Concurrently, a large multicenter, randomized, parallel-group, prospective study will be launched based on evidence-based medical principles to evaluate the efficacy and safety of external methods for removing carrion, dissolving stasis, reinforcing deficiency and promoting tissue regeneration. The evaluated indexes will include the wound healing percentage for primary outcome, wound healing time, wound healing rate, time and rate of removal of necrotic tissue, and TCM syndromes for secondary outcomes and routine blood test, routine urine test, liver and kidney function, blood mercury content and finally urine mercury content for adverse events. DISCUSSION: In this trial, the authors will evaluate the efficacy and safety of external methods for removing carrion, dissolving stasis, reinforcing deficiency and promoting tissue regeneration in cases of chronic ulcer of the lower extremities for standardizing external therapy of TCM for treatment of this condition, and establishing the clinical assessment system for TCM. TRIAL REGISTRATION NUMBER: The research program was registered in the Chinese Clinical Trial Registry in both English and Chinese in June 2011. REGISTRATION NUMBER: ChiCTR-TRC-11001365.

[Effects and action mechanisms of Buyang Huanwu Decoction in wound healing of chronic skin ulcers of rats].

OBJECTIVE: To explore the effects and action mechanisms of Buyang Huanwu Decoction, a compound traditional Chinese herbal medicine, in wound healing of chronic skin ulcers of rats. METHODS: A total of 54 male SD rats with back full-thickness skin lesion were used in this study. Except for the normal control group, the rats were injected with hydrocortisone for inducing chronic skin ulcers, and were randomly divided into untreated group and Buyang Huanwu Decoction group. The rate and the time of wound healing were observed. Immunohistochemical method and image analytical method were used to test the expression of vascular endothelial growth factor (VEGF) and microvessel count (MVC) in granulation tissue of chronic skin ulcers in the rats. RESULTS: The rate of wound healing was significantly lowered in the untreated group as compared with the normal control group (P<0.01, P<0.05), and the time of wound healing was obviously longer too (P<0.01). In the Buyang Huanwu Decoction group, the rate of wound healing was significantly higher than that in the untreated group (P<0.01), and the time of wound healing was obviously shorter than the latter's (P<0.01). In the untreated group, the expression of VEGF and MVC were significantly lower than those in the normal control group (P<0.01); the expression of VEGF and MVC were obviously increased in the Buyang Huanwu Decoction group as compared with those in the untreated group (P<0.01). CONCLUSION: Buyang Huanwu Decoction has the effect to promote the wound healing for chronic skin ulcers of rats by regulating the expression of VEGF in granulation tissue of chronic skin ulcers.

[Effects of Fuhuang Shengji Yuchuang Ointment on expressions of types I and III collagens in granulation tissue of wound in rats with diabetes].

OBJECTIVE: To observe the effects of Fuhuang Shengji Yuchuang (FHSJYC) Ointment, a compound traditional Chinese herbal medicine, on the expressions of types I and III collagens in granulation tissue of wound in rats with diabetes. METHODS: Fifty-four male Wistar rats were randomly divided into three groups: wound control group, normal saline (NS) group and FHSJYC Ointment group. Diabetes was induced by injection of 1.5% alloxan and oral gavage of 5% glucose, and skin wound was made in rats of the NS group and the FHSJYC Ointment group. Skin wounds of the rats in the FHSJYC Ointment group were treated with FHSJYC Ointment gauze dressing, while those in the NS group were treated with NS gauze dressing once daily. The rats were executed in turn on the third day and the eleventh day of the treatment, and the changes of the content of types I and III collagens in the wound granulation tissue were observed by immunohistochemical technology. RESULTS: Compared with the NS group, the wound closure index in the FHSJYC Ointment group was increased (P<0.05). After 3-day treatment, the expression of type I collagen showed no significant differences among the three groups, while the expression of type III collagen in the FHSJYC Ointment group was higher than that in the NS group (P<0.05), similar with that in the wound control group. After 11-day treatment, the expressions of both types I and type III collagens in the FHSJYC Ointment group were higher than those in the NS group (P<0.05), similar with those in the wound control group. CONCLUSION: FHSJYC Ointment can affect the process of wound healing by promoting and regulating the expressions of types I and III collagens.

[Therapy mainly for strengthening healthy energy to promote blood circulation in treating 112 diabetic patients with gangrene].

OBJECTIVE: To evaluate the effects of the therapy mainly for strengthening healthy energy to promote blood circulation in treating diabetic patients with gangrene. METHODS: A series of 112 diabetic patients with gangrene were investigated before and after treatment in the changes of wounds, clinical symptoms and quality of life. RESULTS: Fifty-eight cases were cured, 12 cases showed response, 36 cases improved, and 6 cases failure of treatment. The total obvious effect rate was 62.5% (70/112) and the amputation rate was 8.9% (10/112). The 104 diabetic cases of three-stage gangrene were classified into grade I, II and III. The total effect rates of the diabetic cases of grade I, II and III were 83.3% (30/36), 55.6% (35/63) and 20% (1/5), and the amputation rates were 0%, 12.7% (8/63), and 40% (2/5) respectively. After the treatment, the clinical symptoms, gangrene number, gangrene area and gangrene depth were obviously improved (P<0.05), and the quality of life was obviously improved (P<0.01), especially in physical condition, emotional well-being and therapeutic effects on patients (P<0.05). CONCLUSION: Strengthening healthy energy to promote blood circulation is effective in treating diabetic patients with gangrene.

[Effects of Ru'ai Shuhou Recipe on 5-year recurrence rate after mastectomy in breast cancer].

OBJECTIVE: To observe the effects of Ru'ai Shuhou Recipe (RSR), a compound traditional Chinese herbal medicine, on 5-year recurrence rate after mastectomy in breast cancer. METHODS: A total of 300 patients with breast cancer were divided into two groups: treatment group and control group. The patients in the treatment group were treated with Western medicine and RSR, and the patients in the control group were treated only with Western medicine (the same as the treatment group). In the two groups, the 5-year recurrence rates after mastectomy in breast cancer were investigated. RESULTS: Thirty-four breast cancer patients were lost to five-year follow-up during the course of investigation, and 266 breast cancer patients went through the evaluation. The 5-year recurrence rate after mastectomy in the treatment group was significantly lower than that in the control group (P<0.05). The recurrence rate after mastectomy was influenced by positive lymph node, primary breast tumor size, clinical stage, and patients' health status. There was significant difference in the 5-year recurrence rates between the two groups (P<0.05) under the following conditions, such as the positive lymph nodes more than four, the primary breast tumor larger than two centimeters, and in the clinical stage II and III, estrogen receptor (ER)-positive/progesterone receptor (PR)-positive and ER-negative/PR-negative. The recurrence rate was not associated with the operation method and age distribution. CONCLUSION: RSR can reduce the 5-year recurrence rate after mastectomy in breast cancer.

Effect of runing II on the growth and metastasis of transplanted tumor in mammary cancer-bearing mice and its mechanism.

OBJECTIVE: To study the effect of Runing II (a Chinese herbal preparation for mammary cancer) on the growth and metastasis of transplanted tumor of mammary cancer MA-891-bearing TA2 mice and its mechanism. METHODS: The model of mammary cancer MA-891 cell strain transplanted tumor of TA2 mice with lung metastasis were developed to observe the effect of Runing II on the growth and metastasis of the transplanted tumor. The immunohistochemical method and image analysis were adopted to detect the levels of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor (VEGFR), and micro-vessel count (MVC) and micro-vessel area (MVA). RESULTS: In the Runing II group, the tumor weight inhibition rate and the lung metastasis inhibition rate were 37.3% and 65.4% respectively, the tumor growth and lung metastasis were obviously inhibited; And the levels of VEGF and VEGFR, MVC and MVA were significantly decreased as compared with those in the tumor-bearing control group (P<0.05). CONCLUSION: The Chinese herbal preparation Running II can inhibit the metastasis of tumor through inhibiting the angiogenesis, and the mechanism is possibly related with down-regulation of VEGF and VEGFR expression.

[Effects of Chinese herbs for replenishing qi and resolving stagnation on hypoxia-inducible factor-1alpha and vascular endothelial growth factor in granulation tissue of skin ulcers in rats with diabetes].

OBJECTIVE: To explore the effects of Chinese herbs for replenishing qi and resolving stagnation on hypoxia-inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) in granulation tissue of skin ulcers in rats with syndrome of blood stasis and qi deficiency. METHODS: Diabetic rats with back full-thickness skin lesion and syndrome of blood stasis and qi deficiency were divided in to five groups: untreated group, basic fibroblast growth factor (bFGF)-treated group, Yiqi Huayu Recipe (a recipe for replenishing qi and resolving stagnation)-treated group, Yiqi Recipe (a recipe for replenishing qi)-treated group and Huayu Recipe (a recipe for resolving stagnation)-treated group, and another eight normal rats served as normal control group. Immunohistochemical method and image analysis were used to test the expressions of HIF-1alpha and VEGF in granulation tissue of skin ulcers in rats with diabetes. RESULTS: In the untreated group, the expression of HIF-1alpha was significantly increased and the expression of VEGF was significantly decreased as compared with those in the normal control group (P<0.01). The expression of HIF-1alpha was obviously lower (P<0.01) and the expression of VEGF was significantly higher in the four drug treated groups as compared with those in the untreated group. In the Yiqi Huayu Recipe-treated group, the expression of HIF-1alpha was obviously lower than those in the bFGF-treated, Yiqi Recipe-treated and Huayu Recipe-treated groups (P<0.05 or P<0.01), and the expression of VEGF was significantly higher than that in the bFGF-treated group (P<0.01). CONCLUSION: Chinese herbs for replenishing qi and resolving stagnation can promote the wound healing in rats through reducing the expression of HIF-1alpha, accelerating the expression of VEGF in granulation tissue of skin ulcers in rats with diabetes and ameliorating the status of ischemia and hypoxia.

[Discussion of relationship between quality of life and clinical effect assessment of malignant tumor treated with traditional Chinese medicine].

Traditional Chinese Medicine (TCM) therapy is effective in treating malignant tumor. TCM therapy is a multi-way, multi-layer and multi-target integrated treatment characterized by "survival with tumor" and improvement of life quality. An ideal result of the TCM therapy for cancer should be a positive response of the patient with satisfactory quality of life (QOL) and longer survival time. So it is necessary to introduce the QOL, quantification of symptoms and signs and standardization of TCM syndromes to the objective, quantitative and standardized effect assessment of TCM therapy for cancer. A criterion for evaluating the effect of TCM therapy on tumors should be established, which reflects the characteristics and advantages of the TCM therapy, and meets the requirement of the developing effect assessment of modern medicine in cancer treatment. It is suggested that the treatment effect should be the sum of quality adjusted life years (QALYs) (equal to QOL multiplied by time of survival), syndrome remission rate and tumor remission rate. But the proportion of each of the three is variable, which has close relationships with the different tumor stages and corresponding treatments.

[Succession and innovation of Chinese traditional surgery: a perspective on the history].

Facing the challenge of modern medicine, how to develop Chinese traditional surgery is a question. The tremendous heritage of traditional Chinese medicine (TCM) is the springhead of the development and innovation of TCM. Succession and innovation is an eternal subject for the development of Chinese traditional surgery. In order to improve Chinese traditional surgery, we should explore traditional medical literature, and carry forward the theories of Chinese traditional surgery.