部分脾栓塞治疗难治性原发性血小板减少性紫癜的疗效观察

目的探讨部分脾栓塞在治疗难治性原发性血小板减少性紫癜(ITP)的临床疗效和应用。方法对9例难治性ITP患者进行部分脾栓塞治疗,其中3例短期有效而又复发者进行脾切除治疗,观察和随访其临床疗效。结果9例病人中有8例(包括脾切除术3例)完全缓解,缓解率达88.9%,1例无效。其中随访2年以上4例,1年以上2例,半年以上2例,均无复发。结论部分脾栓塞保留了脾脏的免疫功能,并发症少,临床疗效满意,是治疗难治性ITP安全可靠的方法,亦可作为脾切除治疗难治性ITP的一个手术指标。

Clinical observation of 125 I labeled anti alpha fetoprotein antibody radioimmunotherapy in hepatocellular carcinoma *

AIM To observe the therapeutic effects and toxic side reactions of 125 I labeled hourse anti human AFP polyclonal antibodies in immuno targeting therapy against hepatocellular carcinoma (HCC).

Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment

Hemosuccus pancreaticus is a rare cause of intermittent upper gastrointestinal bleeding. We report two cases of hemosuccus pancreaticus with multiple episodes of upper gastrointestinal bleeding. The causes of hemorrhage were rupture of pseudoaneurysm of the splenic artery and bleeding from the wall of pancreatic pseudocyst. Interventional radiology is the first modality for early diagnosis and possible treatment of hemosuccus pancreaticus. When angiography shows no abnormal findings or interventional radiological therapy can not be successful, surgery should be considered without delay. Our patients herein underwent surgery without recurrence or sequelae. Intraoperative ultrasonography and pancreatoscopy were helpful modalities for confirming the source of hemorrhage and determining the cutting line of the pancreas. When we encounter intermittent upper gastrointestinal bleeding with an obscure source, hemosuccus pancreaticus should be included in differential diagnoses especially in patients with chronic pancreatitis, which would lead to a prompt and proper treatment.

DIAGNOSIS AND TREATMENT OF INSIDIOUS RECURRENT SMALL INTESTINAL HEMORRHAGE

Objective. To improve the localized diagnosis of insidious recurrent small intestinal hemorrhage. Methods. This retrospective analysis include 64 cases of such diseases,which were admitted from 1988 to 1998 to our hospital. Result. Ultrasonography, CT, small bowel pneumobariumgraphy, diluted barium enema,isotopic examination, DSA and intraoperative small-bowel endoscopy were used for diagnosis of hemorrhagic site, and 37 cases got a definite location before operation,while 10 cases were confirmed the diagnosis during the operation.Forty-seven cases were treated surgically, while the other 17 cases had non-surgical treatment.Of the 47 cases,39 cases underwent partial enterectomy, 5 cases had suture and ligature of vascular deformity, 2 cases had Whipple’s operation, and one patient had ectomy of the end of ileum and right colon. Conclusion. DSA, Isotopic examination and intraoperative enteroscopy are of considerable importance for the location judgement of recurrent small intestinal hemorrhage.

A clinical analysis of nutritional therapy in 157 cases with advanced malignancy

Objective： The aim of this study was to evaluate clinical efficacy of nutritional therapy with Kabiven PI and w-3 fish oil fat emulsion on advanced stage of malignant tumor, Methods： One hundred and fifity-seven patients with advanced stage of malignant tumor were performed parenteral nutrition and enteral nutritional adjunctive therapy with Kabiven PI and w-3 fish oil fat emulsion （according to the amount to heat of 20 kcal/kg a day and the nitrogen of 7g/m2.SA）. Results： The ECOG ≥ 3 of 103 cases, therapy interval 2-3 weeks, declined 1 score. 28 were performed with chemotherapeutics under nutritional therapy 2-4 periodical. 25 of 26 died were dead for cancer cachexia and multiple organ failure. Survival time was 2-7 months, No serious complications occurred in all patients, Conclusion： The symptom and quality of life of advanced stage of malignant tumor were obviously improve by nutritional therapy. The opportunity for therapy tumor was offered. It is a important method on combined therapy of malignant tumor.

Uncertainty contribution at NIS phototherapy irradiance facility

Phototherapy lamps are the most effective and safest in the treatment of several medical treatments such as bilirubin. They transfer radiant energy expressed by irradiance unit in W/m2 into the skin specifically to achieve a therapeutic reduction in the bilirubin concentration in the blood. National Institute for Standards （NIS） in Egypt builds up a radiometric method to en- sure the competence of phototherapy sources （luminaire） to the standard international and national requirements. Hence, NIS provides traceability to customer through unbroken chain of phototherapy radiometer calibrated as irradiance response in W/m2. Uncertainty model including all parameters accompanied with the measurements is studied.

Ovulation induction in the gynecological cancer patient

Malignancy is a serious disease that can lead to serious morbidity and mortality. However, the survival rates for women with cancers have increased significantly during the past decades, reflecting improved diagnosis and treatment. With the increased survival in young women with cancer, more attention is being paid to preservation of fertility, which is potentially jeopardized by chemotherapy and radiation therapy, aiming to limit the devastating sequelae of this serious illness by providing these young women with a hope for motherhood. In vitro fertilization with oocyte or embryo cryopreservation has emerged as an astounding method to preserve fertility. It entails induction of ovulation to produce oocytes, the number and quality of which are imperative factors predicting the potential efficacy of the fertility preservation procedure. The aim of this review is to discuss ovarian stimulation for fertility preservation in women with gynecological cancer.

Localization of Auricular Projection Area of the Liver and Its Use in the Monitoring of Viral Hepatitis

Background： Pathology of an internal organ causes significant rectification of electrical currents （diode phenomenon） in related skin areas once the resistance ＇breakthrough effect＇ has been induced in the skin. Objective： Localization of auricular projection area of the liver and evaluation of its usefulness in the monitoring of viral hepatitis. Design, Patients and Setting： Comparative study of the degree of electrical rectification measured at various spots in the auricular concha region, in 19 inpatients with hepatitis B and 15 clinically healthy volunteers, at the Department of Infectious Diseases, Provincial Teaching Hospital, Tychy, Poland. Intervention： Evaluation of electrical rectification at various spots on the auricular concha using a ＂rectification ratio＂ that quantifies the degree of rectification （normal range： 0-60%）. Main outcome measure： The location of the skin area where a statistically significant difference existed between the rectification ratios was observed in patients （82±12% at the time of the ＇peak period＇） versus controls （42±8%）. Results： A location was identified on the ear auricle where the electrical rectification phenomenon demonstrated a dependence on the presence of hepatitis. Conclusions： Liver projection area exists on the ear auricle which is located within the region of cymba conchae, next to anthelix and the cavity of concha. The existence of viral hepatitis causes this skin area to show a higher degree of electrical rectification once the skin resistance ＇breakthrough effect＇ has been induced. Evaluation of the rectification phenomenon of the liver proiection area provides a method of non-invasive monitoring of viral hepatitis.

Safety of anti-tumor necrosis factor therapy in inflammatory bowel disease

Inflammatory bowel disease (IBD), in particular Crohn's disease refractory to conventional therapy, fistulizing Crohn's disease and chronic active ulcerative colitis, generally respond well to anti-tumor necrosis factor (TNF) therapy. However, serious side effects do occur, necessitating careful monitoring of therapy. Potential side effects of anti-TNF therapy include opportunistic infections, which show a higher incidence when concomitant immunosuppression is used. Furthermore, antibody formation against anti-TNF is associated with decreased efficacy and an increased frequency of infusion reactions. The hypothesis of a slightly increased risk of lymphomas in IBD patients treated with anti TNF-therapy is debatable, since most studies lack the specific design to properly address this issue. Alarmingly, the occurrence of hepatosplenic T-cell lymphomas coincides with combined immunosuppressive therapy. Despite the potential serious side effects, anti-TNF therapy is an effective and relatively safe treatment option for refractory IBD. Future research is needed to answer important questions, such as the long-term risk of malignancies, safety during pregnancy, when to discontinue and when to switch anti-TNF therapy, as well as to determine the balance between therapeutic and toxic effects.

The value of radionuclide bone imaging on monitoring chemotherapeutic effects of multiple myeloma

Objective： To investigate the value of radionuclide whole-body bone imaging on monitoring chemotherapeutic ~ffects for multiple myeloma （MM）. Methods： Sixty patients were included. Twenty nine cases received CTD （thalidomide 100-200 rag/d; cyclophosphamide 200-300 mg/m2od, 1-4 days, every 4 weeks; and dexamethasone 20-40 rag/d, 1-4 days, every 4 weeks）; Thirty cases received VAD （vincristine 0.4 mg/d, 1-4 days, every 4 weeks; adriamycin 10 mg/d, 1-4 days, every 4 weeks; dexamethasone 40 rag/d, 1-4 days, every 4 weeks）. Radionuclide bone imagings were performed in all patients before chemotherapy, six months, twelve months and eighteen months after chemotherapy. The correlation of chemothera- peutic effects between CTD and VAD were analyzed. Results： One hundred and seventy nine bone lesions were visualized by bone scintigraphy before CTD treatment. Eighteen months after CTD chemotherapy, it was observed by bone scintigraphy that 39/179 （21.78%） lesions disappeared, 112/179 （62.57%） improved, and 281179 （15.64%） had no change. One hundred and ninety one bone lesions were showed by bone imaging before VAD treatment, 361191 （18.84%） lesions disappeared, eighteen months after chemotherapy, 103/191 （53.92%） improved, and 52/191 （27.22%） had no change. The significant dif- ference was observed in locations of MM induced bone lesions treated with CTD （H = 8.23, P 〈 0.05） and VAD （H = 11.18, P 〈 0.05）. A significant chemotherapeutic sensitivity in detecting MM induced lesions in ribs was found compared with other bone lesions. The chemotherapeutic effect of CTD was statistically significant than that of VAD （U = 2.17, P 〈 0.05）. Conclusion： Radionuclide whole-body bone imaging has great value in monitoring chemotherapeutic effects for MM.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE THERAPY FOR SIMPLE OBESITY COMPLICATED WITH PREMENSTRUAL TENSION SYNDROME

Objective: To observe the therapeutic effect of acupuncture therapy in the treatment of simple obesity complicated with premenstrual tension syndrome. Methods: A total of 39 cases of simple obesity complicated with premenstrual tension were treated by combination of body acupuncture and otoacupuncture based on syndrome-differentiation of traditional Chinese medicine (TCM). Symptoms, physical signs, obesity indexes and cumulative scores of clinical disease-syndrome before and after treatment were analyzed and compared. Results: After one, two and three courses of treatment, the effective rates were 69.23%, 79.49% and 87.18% respectively. Conclusion: Acupuncture therapy works well in the treatment of simple obesity with concurrent premenstrual tension syndrome.

ADVANCES IN CLINICAL AND EXPERIMENTAL STUDIES ON ACUPUNCTURE TREATMENT OF ACUTE CEREBRAL HEMORRHAGE

In the present paper, the authors review recent advances in clinical and experimental studies on acupuncture treatment of cerebral hemorrhage(CH). Regarding clinical studies, the resuscitation-inducing needling maneuver, and main points of Shuigou(水沟GV 26),Baihui(百会 GV 20) and scalp-points Motor Area(MS 6), Sensory Area(MS 7), etc. are often involved. Concerning experimental studies, the underlying mechanisms of acupuncture of GV-26+“Neiguan”(内关 PC 6), GV-20,GV-26+GV-20, etc. in improving acute CH are introduced. In a word, acupuncture therapy works well in improving clinical symptoms and signs of CH patients, and acupuncture stimulation induced ameilioration of cerebral blood flow, favorable modulation of some bioactive substances as excitatory and inhibitory amino acids, endothelin, CGRP, heat shock protein 70, etc. and neuro-endocrine-immune network may contribute to the effect of acupuncture on CH. In addition, acupuncture combined with medicine and earlier application of acupuncture therapy in the acute stage of CH are recommended in clinical practice.

Observation on the therapeutic effect of modified sparrow-pecking moxibustion for 60 cases of osteoarthritis of knee

Objective To observe the therapeutic effect of modified sparrow-pecking moxibustion for osteoarthritis of knee. Methods Sixty cases of patients with osteoarthritis of knee were divided randomly into a treatment group and a control group. The treatment group was treated by modified sparrow- pecking moxibustion, and the control group by traditional sparrow-pecking moxibustion. It was given once a day and 10 times were one course, and the efficacy was observed after two courses of treatment. Results the total effective rate in the treatment group was 90.00% （27/30）, that in the control group was 76.67% （23/30）, the efficacy in the treatment group was better than that in the control group （P〈O.05）. Conclusion Modified sparrow-pecking moxibustion has obvious effect on the treatment of osteoarthritis of knee and it is worthy of being studied and promoted.

Peripheral facial paralysis treated with acupuncture-moxibustion by stages: a multi-central large-sample randomized controlled trial

Objective To explore the best intervention time of peripheral facial paralysis （Bell＇ s palsy） treated with acupuncture-moxibustion and the clinical superiority of acupuncture-moxibustion by stages. Methods Multi- central large-sample randomized controlled trial was carried out. Nine hundred cases of Bell＇ s palsy were randomly divided into 5 treatment groups, named as acupuncture by stages group, acupuncture by stages with moxibustion group, acupuncture by stages with electroacupuncture group, acupuncture by stages with line-puncture on muscle region of meridian group and acupuncture without stages group. Four sessions of treatment were required in each group. The clinical curative effects of groups were assessed by House-Brackmann Scale, Facial Disability Index Scale and Degree of Facial Nerve Paralysis Scale during the enrollment, after 4 sessions of treatment, and during 1 and 3 months of follow-up after treatment. The systematic analysis of curative effects was provided in view of the intervention time and nerve localization of disease separately. Results The cure rates of intervention treatment were 50.1% （223/445） in acute stage and 52.1% （162/311） in resting stage, superior to that of 25.9% （35/135） in recovery stage （both P〈0.001）. There was no statistically significant differences in comparison of curative effect in 5 solutions at the same stage （all P〉0.05）. The effect of treatment intervened at acute stage was superior to that at recovery stage in acupuncture by stages group and acupuncture without stages group （both P〈0.01）. There were statistically significant differences in curative effect of the localization above and below chorda tympani nerve in acupuncture by stages with line-puncture on muscle region of meridian group （P〈0.01）. The curative effect of the localization below chorda tympani nerve was superior to that above the nerve. Conclusion The best intervention time for Bell＇ s palsy is at acute stage and resting stage, meaning 1 to 3 weeks after occurrence. All 5 solutions are clinical superiorities to Bell＇s palsy. Under the condition of limited medical sources, the simple filiform needle puncture is recommended at acute stage. For the patients with the disorder above chorda tympani nerve, line-puncture on muscle region of meridian is not recommended.

Clinical Research on Comprehensive Treatment of Senile Vascular Dementia

Objective:To observe the curative effect of combined Chinese medicine,acupuncture and rehabilitation therapy on vascular dementia(VD),and to compare the Western medicine piracetam.Methods:Total 134 VD patients screened in reference to the standard for VD diagnosis in DSM-IV were randomly divided into a Chinese medicine plus rehabilitation group(32 cases),a Chinese medicine plus acupuncture group(33 cases),a Chinese medicine and acupuncture plus rehabilitation group(37 cases) and a Western medicine piracetam group(32 cases).Mini Mental State Examination(MMSE) and Bless Behavior Scale(BBS) were used to assess changes in intelligence disorder before treatment and after 12-week treatment.Results:BBS score,living ability and daily habit were enhanced after treatment in all groups.Cognitive function and behavioral ability were improved with similar total curative effects in all the 4 groups.Directional ability and short-term memory ability were significantly enhanced after treatment(P<0.05) in both the Chinese medicine plus rehabilitation group and the Chinese medicine plus acupuncture group groups.Living ability was significantly improved after treatment in the Chinese medicine and acupuncture plus rehabilitation group(P<0.01).However,no obvious difference was shown before and after treatment in the piracetam group.Conclusion:The improvement of living ability in the comprehensive treatment group is better than that in the other groups.Chinese medicine and acupuncture plus rehabilitation treatment can improve intelligence and living ability of senile VD patients.

Clinical observation on acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy

Objective： To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods： A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 （PDMS-2） and modified Ashworth scale （MAS） before and after treatment. Results： After treatment, the standard score for grasping （Grs）, standard score for visual-motor integration （Vis）, fine motor quotient （FMQ） and modified Ashworth scale （MAS） were significantly improved in both groups （P〈0.05）. The improvement in the treatment group was more obvious than that in the control group （P〈0.01）. Conclusion： Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.

Colon hydrotherapy plus Traditional Chinese Medicine to treat non-alcoholic fatty liver disease:a pilot study

OBJECTIVE: To demonstrate the potential to treat non-alcoholic fatty liver disease(NAFLD) with colon hydrotherapy(CHT) plus Traditional Chinese Medicine(TCM).METHODS: A total of 20 patients were enrolled into the study and received CHT with TCM for 2 weeks.Body mass index(BMI) and levels of serum triglycerides(TG) and total cholesterol(TC) were compared between pre-treatment and post-treatment.RESULTS: Two-week treatment with CHT plus TCM significantly lowered BMI and reduced blood lipids.BMI decreased from 29.5 ± 4.3 to 25.4 ± 1.0, while mean TG levels decreased by 0.70 mmol/L on average from baseline and mean TC levels decreased by0.37 mmol/L. Forty-five percent of patients exhibited TC decreasing by more than 10% from baseline and25%ofpatientsexhibited TCdecreasingbymore than 20%. Sixty percent of patients exhibited TG decreasing by more than 20% and 20% of patients exhibited TG decreasing by more than 40%. However,high-density and low-density lipoprotein cholester-ol levels did not change significantly after intervention. No serious adverse events were reported.CONCLUSION: Our findings suggest that CHT plus TCM to treat NAFLD is promising and it might be a new treatment strategy for management of NAFLD.

The Needle-Rolling Therapy for Treatment of Non-organic Chronic Insomnia in 90 Cases

Objective: To evaluate the therapeutic effects of needle-rolling therapy for chronic insomnia. Methods: In the present multi-central randomly controlled clinical study, 180 cases of chronic insomnia were randomly divided into the following two groups, a treatment group (90 cases) treated by the needle-rolling therapy and a control group (90 cases) treated with clonopin. The treatment course for both the two groups was 4 weeks. The therapeutic effects were evaluated based on improvement of the TCM symptoms and the Pittsburgs's sleep-quality index (PSQI). Results: After treatment, there were significant differences between the two groups in the effective rate (P<0.05), and in the total score of PSQI and in the scores of the 4 sub-items, i.e. sleep-quality, sleep-efficiency, hypnotic and daytime function (P<0.05). Although there was no significant difference between the two groups in the effective rate after a 3-month follow-up period, significant differences still existed in the 3 sub-items of sleep-efficiency, hypnotic, and daytime function of the PSQI (P<0.05). Conclusion: As compared with hypnotics of the second generation, the needle-rolling therapy may show better therapeutic effects for chronic insomnia patients.