Clinical efficacy of Qianjin Weijing Decoction in the treatment of severe pneumonia with accumulation of phlegm and heat in the lung / 中国基层医药

Objective:To investigate the clinical efficacy of Qianjin Weijing Decoction in the treatment of severe pneumonia with the accumulation of phlegm and heat in the lung. Methods:Eighty patients with severe pneumonia with the accumulation of phlegm and heat in the lung received treatment in Wenzhou Hospital of Traditional Chinese Medicine from December 2018 to December 2020. They were randomly allocated to undergo routine treatments (control group, n = 40) or routine treatments combined with Qianjin Weijing Decoction (observation group, n = 40) for 7 days. Clinical efficacy, blood gas analysis, oxygenation index, inflammatory factors (C-reactive protein and procalcitonin), and sequential organ failure score were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group [87.50% (35/40) vs. 65.00% (26/40), χ2 = 5.59, P < 0.05]. Partial pressure of carbon dioxide (PaCO 2) post-treatment was significantly lower in the observation group than that in the control group [(30.24 ± 2.68) mmHg vs. (39.95 ± 3.27) mmHg, t = 14.52, P < 0.05]. The partial pressure of blood oxygen (PaO 2) and oxygenation index (PaO 2/FiO 2) in the observation group were (76.85 ± 4.56) mmHg and (326.84 ± 8.49) mmHg, respectively, which were significantly higher than those in the control group [(68.39 ± 4.12) mmHg, (284.16 ± 15.56) mmHg, t = -8.70, -15.22, both P < 0.05). Serum levels of C-reactive protein and procalcitonin post-treatment in the observation group were (23.12 ± 6.56) mg/L and (0.31 ± 0.08) μg/L, respectively, which were significantly lower than those in the control group [(38.92 ± 5.62) mg/L, (0.78 ± 0.20) μg/L, t = 11.56, 13.80, both P < 0.05]. Sequential organ failure score was significantly lower in the observation group than in the control group [(2.31 ± 0.46) points vs. (5.12 ± 1.25) points, t = 13.34, P < 0.05)]. Conclusion:Qianjin Weijing Decoction has a good therapeutic effect on severe pneumonia with the accumulation of phlegm and heat in the lung. The treatment can improve blood gas analysis and decrease inflammatory factor levels with a good prognosis.

Effects of finasteride combined with tamsulosin hydrochloride on glandular microvessel density during the perioperative period in patients with benign prostatic hyperplasia / 中国基层医药

Objective:To investigate the effects of finasteride combined with tamsulosin hydrochloride administered during the perioperative period on glandular microvessel density in patients with benign prostatic hyperplasia.Methods:Ninety patients with benign prostatic hyperplasia who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2017 to August 2019 were included in this study. They were randomly assigned to receive either oral tamsulosin hydrochloride alone (control group, n = 45) or oral finasteride combined with tamsulosin hydrochloride (observation group, n = 45) during the perioperative period of transurethral resection of the prostate. All patients received 6 weeks of medication. Clinical efficacy, adverse reactions, and urodynamic indexes, glandular microvessel density, International Prostatism Symptom Score, bother score, and urine color/degree of haematuria score pre- and post-treatment were compared between the two groups. Results:The maximum urinary flow rate in each group significantly increased 6 weeks after treatment compared with before treatment. The detrusor pressure and residual urine volume in each group decreased 6 weeks after treatment compared with before treatment. After 6 weeks of treatment, the maximum urinary flow rate was significantly higher in the observation group than in the control group [(15.63 ± 2.26) mL/s vs. (13.14 ± 2.23) mL/s], and residual urine volume was significantly lower in the observation group than in the control group [(29.19 ± 4.81) mL vs. (32.25 ± 5.52) mL, t = 5.26, 2.80, both P < 0.05). International Prostatism Symptom Score measured 6 weeks after treatment and urine color/degree of haematuria score measured 1 week after treatment were (12.09 ± 2.17) points and (1.51 ± 0.27) points, respectively in the observation group, which were significantly lower than those in the control group [(14.28 ± 2.22) points, (2.03 ± 0.38) points, t = 4.73, 7.48, both P < 0.05]. Factor VIII related antigen- and CD34-positive glandular microvessel density values in the observation group were (14.74 ± 3.05) counts/visual field and (19.41 ± 3.07) counts/visual field, respectively, which were significantly lower than those in the control group [(18.08 ± 3.16) counts/visual field, (22.27 ± 3.16) counts/visual field, t = 5.10, 4.35, both P < 0.05]. The incidence of postoperative hematuria was significantly lower in the observation group than in the control group [15.56% (7/45) vs. 35.56% (16/45), χ2 = 4.73, P < 0.05]. Conclusion:Compared with tamsulosin hydrochloride alone, finasteride combined with tamsulosin hydrochloride administered during the perioperative stage can greatly improve the urodynamic indexes of patients with benign prostatic hyperplasia, reduce microvessel density value, International Prostatism Symptom Score, bother score, and decrease the incidence of hematuria. The combined therapy provides a novel idea for preventing perioperative bleeding in patients with benign prostatic hyperplasia.

Value of Traditional Chinese Medicine syndrome differentiation in predicting the survival time of patients with advanced cancer.

OBJECTIVE: To prospectively study the accuracy of the palliative prognostic index (PPI) survival prediction model combined with Traditional Chinese Medicine (TCM) syndrome differentiation. METHODS: The PPI survival prediction model was used to predict survival time. Patients' real survival time was recorded. The survival time was calculated using the Kaplan-Meier method, and the logrank method was used to test the difference. RESULTS: The average PPI survival prediction score of 227 patients was 5.83 (95% CI: 5.29-6.37). There was a significant difference in the real-life period between the different PPI groups (P < 0.05). PPI group I (predicted survival of > 6 weeks) showed the highest predictive sensitivity and PPI group II (predicted survival of 3-6 weeks) showed the highest predictive specificity. According to TCM syndrome differentiation, 82 cases (36% ) were diagnosed with liver and kidney Yin deficiency (type IV). The actual survival time of type IV patients was significantly shorter than that of other types of patients (mean: 21.85 vs 28.70, P = 0.007). In group I, the median survival time of type IV patients and other types was 25 and 34 d, respectively (P < 0.001). The sensitivity and specificity of PPI prediction were improved in group II by TCM syndrome differentiation. For patients in group III whose predicted survival time was < 3 weeks, the specificity of PPI survival prediction was higher in type IV patients. CONCLUSION: This study shows that the PPI predictive tool for survival rate has important value. TCM syndrome differentiation and typing has certain significance for further classification and survival prediction.

[Long-term outcome comparison of ostial/shaft lesions in unprotected left main coronary artery treated by PCI or CABG].

Objective: To evaluate long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) and percutaneous coronary intervention(PCI) with drug-eluting stents(DES) for ostial/shaft lesions in unprotected left main coronary artery(ULMCA). Method: A total of 259 patients with isolated ostial/midshaft lesions in unprotected left main coronary artery were enrolled consecutively who received DES implantation or underwent CABG between January 2003 and July 2009 in Beijing Anzhen Hospital. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI) and stroke. Time to the primary endpoint was evaluated according to the Kaplan-Meier method, and the log-rank test was applied to compare the incidence of the endpoint. Adjusted risks for adverse outcomes were compared by multivariate Cox proportional hazard regression analyses. Results: A total of 259 patients were included, including 149 in PCI group and 110 in CABG group. And 193(74.5%) cases were males.The age was (61.4±9.8) years old. The median follow-up was 10.1 years (interquartile range 8.3 to 11.2 years) in the overall patients. There were no significant difference for the incidence of death [37.0% vs. 43.1% ，P=0.143] , MI [34.0% vs. 19.4% ，P=0.866], stroke [6.4% vs. 11.7% ， P=0.732], repeart revascularization [33.6% vs. 39.9% ，P=0.522] between PCI group and CABG group before multivariate adjusting，according to the incidence calculated with Kaplan-Meier. After adjusting covariates such as age, left ventricular ejection fraction（LVEF） and serum creatine with multivariate Cox hazard regression model, there was still no significant difference between the two groups. Conclusions: PCI with DES is as effective and safe as CABG in patients with left main ostium/shaft lesion during a median follow-up of 10.1 years.

Long-term outcome comparison of ostial/shaft lesions in unprotected left main coronary artery treated by PCI or CABG / 中华心血管病杂志

Objective: To evaluate long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) and percutaneous coronary intervention(PCI) with drug-eluting stents(DES) for ostial/shaft lesions in unprotected left main coronary artery(ULMCA). Method: A total of 259 patients with isolated ostial/midshaft lesions in unprotected left main coronary artery were enrolled consecutively who received DES implantation or underwent CABG between January 2003 and July 2009 in Beijing Anzhen Hospital. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI) and stroke. Time to the primary endpoint was evaluated according to the Kaplan-Meier method, and the log-rank test was applied to compare the incidence of the endpoint. Adjusted risks for adverse outcomes were compared by multivariate Cox proportional hazard regression analyses. Results: A total of 259 patients were included, including 149 in PCI group and 110 in CABG group. And 193(74.5%) cases were males.The age was (61.4±9.8) years old. The median follow-up was 10.1 years (interquartile range 8.3 to 11.2 years) in the overall patients. There were no significant difference for the incidence of death [37.0% vs. 43.1% ，P=0.143] , MI [34.0% vs. 19.4% ，P=0.866], stroke [6.4% vs. 11.7% ， P=0.732], repeart revascularization [33.6% vs. 39.9% ，P=0.522] between PCI group and CABG group before multivariate adjusting，according to the incidence calculated with Kaplan-Meier. After adjusting covariates such as age, left ventricular ejection fraction（LVEF） and serum creatine with multivariate Cox hazard regression model, there was still no significant difference between the two groups. Conclusions: PCI with DES is as effective and safe as CABG in patients with left main ostium/shaft lesion during a median follow-up of 10.1 years.

Long non-coding RNA biomarker for human laryngeal squamous cell carcinoma prognosis.

Long non-coding RNAs (lncRNA) were discovered in tumors. The regulation of lncRNA in human laryngeal squamous cell carcinoma (LSCC) remains incomplete. Uncovering the potential of lncRNA to stratify the prognosis of LSCC and streamline the vast amount of clinical information will affect medical interventions. The surgical resected LSCC tissues, adjacent non-cancerous tissues (ANCT) and lymph node metastatic tissue (LNM) were collected from 76 patients for lncRNA AC008440.10 expression assay. The stages of LSCC and LNM were classified accordingly. We integrated the epigenetic information with enhanced CT imaging and pathological evaluations to predict the patients' survival by comprehensive statistical algorithms using equal weighting. Significant downregulation of lncRNA AC008440.10 was detected in LSCC tumor and metastatic lymph node in advanced stage of patient samples compared with those in early stage. The pattern of differentially expressed AC008440.10 displayed a clear trend that significantly related to tumor progression. The downregulation of lncRNA AC008440.10 correlates with increasing risk of metastasis, poor prognosis and patient survival. The potential for lncRNA AC008440.10 to be developed as a novel biomarker for stratification of the prognosis was especially promising when clinic parameters were hybridized with equal weight, and using a panel of complementary parameters yielded a more powerful predictability of LSCC prognosis than any single parameter individually.

Correlation between copeptin and the disease severity, outcome and stress hyperglycemia in severe pneumonia patients / 中华急诊医学杂志

Objective To study the changes of plasma copeptin level in pneumonia patients and to explore the correlation between copeptin and disease severity,outcome as well as stress hyperglycemia.Methods A total of 45 patients with severe pneumonia were included in a prospective observation.The plasma levels of copeptin,CRP and blood glucose were measured after admission,and the APACHE Ⅱ scores were recorded within 24 hours.The patients were given insulin therapy by intravenous micro-dosage pump,and the total doses of insulin were recorded.All the patients with 28-day survival were followed up.Results The plasma levels of copeptin of severe pneumonia patients after admission were positively correlated with APACHE Ⅱ (r =0.481,P =0.001) and blood glucose (r =0.417,P =0.004),and were also correlated with the total insulin doses in patients under insulin therapy (blood glucose ≥ 10.0 mmol/L).The plasma levels of copeptin of the survival group were significanatly higher than the non-survival group,COX regression multivariate analysis showed that copeptin was an independent risk factor of death in severe pneumonia patients (P =0.005,OR =1.022,95％ CI:1.00-1.044),and the area under the ROC curve was 0.740 9 (P =0.006).Conclusion The plasma levels in all patients with copeptin of severe pneumonia after admission is positively correlated with APACHE Ⅱ and stress hyperglycemia,suggesting a useful approach to the judgment of disease severity,outcome and glucose control.

Disease assessment in systemic vasculitis.

The anti-neutrophil cytoplasm antibody-associated vasculitides are complex multi-system disorders with many overlapping clinical features. Their outcome has been transformed by effective immunosuppression, preventing death in over 70% of cases. The quality of survival is affected by the disease course, which is characterized by a significant likelihood of relapse in 38%, chronic effects from the disease and its treatment, as well as emerging or worsening comorbidity, all of which contribute to the patient's clinical condition and outcome. Whilst imaging and laboratory testing including histology are important aspects of diagnosis, they are of limited value in assessing response to therapy or subsequent disease course. We have developed standardized validated clinical methods to quantify disease activity and damage; we are developing effective measures of patient experience to complement these procedures. This approach provides a rational basis for clinical management as well as being essential in the conduct of clinical trials and studies in vasculitis, by providing reproducible definitions of relapse, remission and response to therapy for patients with systemic vasculitis. Clinical assessment remains the current gold standard for evaluating disease progress, but requires regular training to ensure standardization. The development of biomarkers in future may produce a more accurate description of disease and identify potential targets for therapy as well as predictors of response to drugs.

Transcatheter Arterial Chemoembolization in Elderly Patients with Primary Hepatocellular Carcinoma / 中国医学影像学杂志

Purpose Elderly patients with primary hepatocellular carcinoma (HCC) have gradually increased in recent years. Most patients also have systemic disease with poor cardiac and pulmonary function, thus can only receive non-surgical treatment. This paper is to assess the clinical efficacy of transcatheter arterial chemoembolization (TACE) and prognostic factors of HCC in elderly patients. Materials and Methods A retrospective analysis was performed in 106 patients with HCC diagnosed by US, dynamic CT or dynamic MRI [average age (74.9±3.3) years, range 71-84 years] and treated by TACE. The clinical characteristics, survival and prognosis factors were analyzed. Results Follow-up was performed at a median of 18 months (range 1–40 months). The 1-, 2-, and 3-year overall survival (OS) rates were 80.2%, 42.5% and 22.6%, respectively. Univariate analysis showed that the patient's gender and cirrhosis, HBV/HCV infection, diabetes and systemic disease were not significantly correlated with prognosis (P>0.05). Child grade, Eastern Cooperative Oncology Group (ECOG) grade, tumors size, number of tumors, serum alpha-fetoprotein level, portal vein tumor thrombus and Barcelona clinic liver cancer stage were significantly related to OS (P<0.05, P<0.001). Moreover, the Cox multivariant survival analysis revealed that portal vein tumor thrombus, tumor size, serum alpha-fetoprotein level and ECOG stage were independent prognostic indicators (P<0.05, P<0.001). Conclusion Systemic disease does not impact long-term survival in elderly patients with HCC. Portal vein tumor thrombus, tumor size, serum alpha-fetoprotein level, and ECOG grade are independent prognostic indicators.

Prognotic analysis of 132 cases with gastrointestinal stromal tumors / 肿瘤研究与临床

Objective To analyze the survival rates of gastrointestinal stromal tumors (GISTs),and the influence of surgical treatment and imatinib to the survival times.Methods The clinical data of 132 patients with GIST who were admitted to Peoples Liberation Army Hospital from January 2003 to December 2013 were retrospectively analyzed.Results All the patients were followed up with a median time of 22 months (1-83 months).The survival rates of 1-year,3-year,5-year were 99 ％,96 ％,92 ％ in this study.The tumor located at cardiac part,fundus of stomach,greater curvature,lesser curvature and pylorus part was 19 cases (14.4 ％),34 cases (25.8 ％),38 cases (28.8 ％),38 cases (28.8 ％) and 3 cases (2.3 ％),respectively.The positive rates of CD117,CD34 and Ki-67 was 116 cases (87.9 ％),119 cases (90.2 ％),51 cases (38.6 ％).According to Fletcher risk classification,the patients of high-low risk,low risk,intermediate risk,and high risk were 10 cases (7.6 ％),34 cases (25.8 ％),14 cases (10.6 ％),and 74 cases (56.1％),respectively.The differences of survive rates in the different excision method and imatinib treatment had statistics significance (P =0.000).The differences of survive rates in Fletcher risk classification had statistics significance (P =0.028).However,the differences of survive rates in location of gastric GIST showed no significant difference (P ＞ 0.05).Conclusions GIST in different parts of gastric have not obviously different survival rates,respectively.The total resection and imatinib treatment could raise the survival rates of patients with GIST.

Procalcitonin as a Prognosis Marker for the Severe Sepsis and Septic Shock Patients in Emergency Department / 대한구급학회지

BACKGROUND: Advance in sepsis management has increased the survival of patients with sepsis. However, severe sepsis and septic shock patients still have high mortality. We intend to verify the use of the procalcitonin (PCT) level as a prognosis marker in patients with severe sepsis or septic shock in the emergency department (ED). METHODS: ED Patients with severe sepsis or septic shock were enrolled in our study. We used mortality and Intensive Care Unit (ICU) days as a prognosis index, and compared the PCT level in survivors and non-survivors. We introduced the simplified acute physiology score 3(SAPS3) to assess the severity of the patients and analyzed whether or not the PCT level correlated with the severity index. RESULTS: The PCT level in septic shock patients [7.36 (0.92-33.69, IQR)] was higher than that in severe sepsis patients [3.24 (0.36-10.53, IQR)] (p = 0.04). However, there was no significant PCT level difference between survivors [median (IQR), 6.59 (0.60-29.25)] and non-survivors [median (IQR), 3.49 (0.40-20.41)] (p = 0.293). The SAPS3 score was higher in the non-survivor group [median (IQR), 64 (59.0-71.5)] than in the survivor group [median (IQR), 77 (68.5-82.0)] (p = 0.001). The PCT level did not correlate with either ICU days or hospital days. CONCLUSIONS: Using the PCT level as a prognosis factor in severe sepsis and septic shock patients in ED has little value.

To Analyze the Relation Between the Blood Glucose and the Clinical Aspects of Acute Bischemic Stroke / 医学研究杂志

Objective To explore the relation between the blood glucose and the clinical aspects of acute bischemic stroke.Methods 164 patients with acute cerebral infarction were divided into threegroups:normal glycemic group,diabetes hyperglycemic group and non-diabetes hyperglycemic group.To study the relation between blood glucose and clinical aspects of bischemic stroke.Results There were significant differences in curatio improvement rate among the three groups(P

Expression of midkine protein in non-small-cell lung cancer and its clinical significance / 中国癌症杂志

Purpose:To investigate the features of midkine( MK) protein expression and the correlation between MK expression with angiogenes is and prognosis in non-small-cell lung cancer(NSCLC). Methods:Immunohistochemistry analysis for MK and microvessel de nsity(MVD) were performed on 44 samples of tumor tissue. Results:No positivity expression was detected in either the lun g tissue close to tumor or normal lung tissue,but 26 of 44 NSCLC tissue showed a positive reaction to MK immunostain. Significant correlation between MK express ion with MVD enhancement and lymph metastasis in NSCLC was found,and the surviva l terms in NSCLC with MK expression were significantly shorter than those in NSC LC without MK expression.The enhanced MVD was related to lymph metastasis signif icantly,and the survival terms in NSCLC with enhanced MVD were significantly sho rter than those in NSCLC without enhancement. Conclusions:In human non-small-cell lung cancer, MK overexpre ssion at the protein level may very well be closely related to angiogenesis and metastasis. MK protein may be one of the predictors for prognosis in NSCLC.

Post-operative radiotherapy for renal cell carcinoma: reterospective analysis of 90 patients / 中华放射肿瘤学杂志

Objective To evaluate the efficacy of post-operative radiotherapy and prognosis of renal cell carcinoma(RCC). Methods Between 1981 and 1998 , 90 s uch patients with disease limited to the kidney underwent nephrectomy at our ins titution. According to TNM classification(UICC,1997) the pathological stage was: Ⅰin 27 patients(30%),Ⅱ in 18 (20%), Ⅲ in 35(38.9%), and Ⅳ in 10(11.1%).Post - operative irradiation, with a median dose of 50?Gy in 25 fractions over 5 weeks w as given to 52 patients in 3～5weeks after surgery, using AP-PA opposing portal s or oblique portals. Results The 5- and 10-year survival rates in the irradiate d patients(S+Rt) were 75% and 60%,respectively, but in the non-irradiated patien t s(S) 50% and 40%, respectively.This difference is statistically significant. 5- y ear survival rates by TNM stage in the two groups were as follows: stageⅠ:S 67 %,S+Rt 100%;stageⅡ: S 55%,S+Rt 71%;stageⅢ: S 47%,S+Rt 65% (P=0 .010);stageⅣ: S 0%, S+Rt 43%.Diseases recurred locally in a total of 12 patients: 3 had tumo r b ed recurrence and 6 had regional lymph node recurrence and 3 had both. Local rec urrence in S was 29% and that of S+R was 2% (P=0.001). and local recurrence by T NM stage:Ⅲ were 33% and 5%, respectively. One patient developed radiation-indu c ed small bowel obstruction which necessitated surgical intervention, but no pat i ent died from radiotherapy-induced complications. By multivariate analysis: per f ormance status, symptomatic presentation, lymph node involvement, post-operativ e radiation and post-operative residual were all independent predictors of overa l l survival in the RCC patients. Conclusions In renal cell carcinoma, radiothera py is beneficial in reducing the locoregional recurrence. Radiotherapy has a sup prisingly positive effect on both local control and survival in TNM stage Ⅲ pat ients. Performance status, symptomatic presentation, lymph node involvement, pos t-operative radiation and post-operative residual are prognostic indicators of RCC. TNM staging is superior to Robson staging in predictive values .