载伊立替康微球经肝动脉栓塞联合全身化疗与单纯全身化疗对不可切除胃癌肝转移的疗效比较

目的 比较胃癌不可切除且伴随肝转移患者,单独化疗及其与载伊立替康微球经肝动脉栓塞(DTACE)联治的效果差异。方法 回顾性分析2017年6月1日-2019年6月1日阳新县人民医院肿瘤科收治的胃癌不可切除且伴随肝转移患者80例的临床资料,按照不同疗法分为甲组和乙组,每组40例。甲组给予替吉奥与伊立替康化疗,乙组在甲组基础上给予伊立替康DTACE联治。比较2组患者治疗前后血清指标[血管内皮生长因子(VEGF)、胸苷激酶1(TK1)水平]、免疫功能指标(CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))变化,治疗的效果和生存质量,以及不良反应。结果 治疗后,2组VEGF、TK1水平均较治疗前降低,且乙组水平低于甲组(P均<0. 01);治疗后,2组CD4^(+)、CD4^(+)/CD8^(+)值较治疗前升高,乙组CD4^(+)、CD4^(+)/CD8^(+)值高于甲组,CD8^(+)值低于甲组(P均<0. 01);乙组患者总有效率为67. 50%,高于甲组的45. 00%(χ^(2)=4. 114,P=0. 043);乙组生存质量降低率为25. 00%,低于甲组的50. 00%(χ^(2)=5. 333,P=0. 021);2组不良反应总发生率比较差异无统计学意义(χ^(2)=0. 050,P=0. 823)。结论 与单纯化疗相比,结合伊立替康DTACE联治胃癌不可切除且伴随肝转移的患者疗效更明显,可改善患者血清指标和免疫功能,治疗总有效率高,提高患者生存质量,值得临床推广应用。

Efficacy of MK615 for the treatment of patients with liver disorders

AIM： To investigate the hepatoprotective effect of MK615, a Japanese apricot extract, in an animal model, and its clinical therapeutic effect. METHODS： Wistar rats were administered physiologi- cal saline （4 mL/kg） or MK615 solution （4 mL/kg） for 7 d. On the sixth d, acute hepatic injury was induced by administering a single intraperitoneal injection （ip） of D-galactosamine hydrochloride （D-GaIN） （600 mg/kg）. Plasma levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were determined, and liver tissues were used for histopathological analy- sis. Fifty-eight patients with liver disorders [hepatitis C （n = 40）, non-alcoholic fatty liver disease （n = 15）, and autoimmune liver disease （n = 3）] were orally admin- istered commercially available Misatol ME-containing MK615 （13 g/d） daily for 12 wk. Blood and urine were sampled immediately before and 6 wk, 12 wk, and 16 wk after the start of intake to measure various bio- chemical parameters. The percentage change in ALT and AST levels after 12 wk from the pre-intake baseline served as a primary endpoint. RESULTS： D-GaIN effectively induced acute hepatic injury in the rats. At 48 h after the ip injection of D-GaIN, the plasma levels of ALT （475.6 ：t： 191.5 IU/L vs 225.3 ＋ 194.2 IU/L, P 〈 0.05） and AST （1253.9：1：223.4 IU/L vs 621.9 ＋ 478.2 IU/L, P 〈 0.05） in the MK615 group were significantly lower than the control group. Scattered single cell necrosis, loss of hepatocytes, and extensive inflammatory cell infiltration were observed in hepatic tissue samples collected from the control group. However, these findings were less pronounced in the group receiving MK615. At the end of the clinical study, serum ALT and AST levels were significantly de- creased compared with pre-intake baseline levels from 103.5 ：l： 58.8 IU/L to 71.8 ＋ 39.3 IU/L （P 〈 0.05） and from 93.5 ：E 55.6 IU/L to 65.5 ＋ 34.8 IU/L （P 〈 0.05）, respectively. A reduction of 〉~ 30% from the pre-study baseline ALT level was observed in 26 （45%） of the 58 patients, while 25 （43%） patients exhibited similar AST level reductions. The chronic hepatitis C group exhibit- ed significant ALT and AST level reductions from 93.4：1： 51.1 IU/L to 64.6 ＋ 35.1 IU/L （P 〈 0.05） and from 94.2 ＋ 55.5 IU/L to 67.2：1：35.6 IU/L （P 〈 0.05）, respective- ly. A reduction of 〉~ 30% from the pre-study baseline ALT level was observed in 20 （50%） of the 40 patients.ALT levels in both the combined ursodeoxycholic acid （UDCA） treatment and the UDCA uncombined groups were significantly lower after Misatol ME administration. MK615 protected hepatocytes from D-GaiN-induced cytotoxicity in rats. Misatol ME decreased elevated ALT and AST levels in patients with liver disorders. CONCLUSION： These results suggest that MK615 and Misatol ME are promising hepatoprotective agents for patients with liver disorders.

AIDS Treatments Efficiency Analysis Based on Cost Efficiency Data Envelopment Analysis Model

Three data envelopment analysis (DEA) models were used to analyse the relative efficiencies of four AIDS treatments in AIDS Clinical Trial Group (ACTG) Study 193A(1 309 patients in total, classified into 4 age groups). Results from the output-oriented BCC model show that Treatment 4 ( 600 mg of zidovudine plus 400 mg of didanosine plus 400 mg of nevirapine) is particularly efficient for age group 14—25, but not efficient for the older age groups; Treatment 1 (600 mg of zidovudine alternating monthly with 400 mg of didanosine)and Treatment 2 (600 mg of zidovudine plus 2.25 mg of zalcitabine) are efficient for the age groups 35—45 and 45— ; age group 25—35 does not have a particularly efficient treatment, but Treatments 1 and 2 are relatively good. The cost efficiency BCC model, which takes the treatment cost into account, gives similar results as the output-oriented model. Results from the indirect output-oriented BCC model, which allows the replacement among medicines, show that the efficiency of Treatment 2 has greatly decreased compared with that of the output-oriented model, and a set of optimal medicine amounts for different age groups is obtained.

Itopride therapy for functional dyspepsia:A meta-analysis

AIM:To evaluate the therapeutic effects of itopride vs other drugs(placebo,domperidone,mosapride) for functional dyspepsia(FD).METHODS:Randomized controlled trials(RCTs) of itopride for FD were retrieved from databases.Relevant information was extracted and analyzed,using the relative risk(RR) and weighted mean deviation,as appropriate.A random or fixed effect model was used,based on the heterogeneity of the included articles,and visual inspection of funnel plots was used to evaluate publication bias.RESULTS:Nine RCTs enrolling 2620 FD cases were included;1372 cases received itopride treatment and 1248 cases received placebo or other drugs(control groups).Compared with control groups,itopride had superior RR values of 1.11 [95%CI:(1.03,1.19),P = 0.006],1.21 [95%CI:(1.03,1.44),P = 0.02],and1.24 [95%CI:(1.01,1.53),P = 0.04] for global patient assessment,postprandial fullness,and early satiety,respectively.For the Leeds Dyspepsia Questionnaire score,the weighted mean deviation was-1.38 [95%CI:(-1.75,-1.01),P < 0.01].The incidence of adverse effects was similar in the itopride and control groups.The funnel plots for all indicators showed no evidence of publication bias.CONCLUSION:Itopride has good efficacy in terms of global patients assessment,postprandial fullness,and early satiety in the treatment of patients with FD and shows a low rate of adverse reactions.Itopride can greatly improve FD syndromes-score.

Comparative Analysis of Intractable Postpartum Hemorrhage Intervention Treatments

Abstract： Objective： To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods： From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results： The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group （P 〈0.05）, and complication rate of observation group is significantly lower than the control group （P 〈0.05）. Conclusions： In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.

Comparative Analysis of Intractable Postpartum Hemorrhage Intervention Treatments

Objective： To explore the clinical efficacy of different treatment methods of intervention for intractable postpartum hemorrhage. Methods： From the accept and treat patients with intractable postpartum hemorrhage in our hospital from June 2013 to March 2014, 86 cases were chosen to be retrospectively analyzed, randomly divided into observation group and control group with 43 cases in each group. The control group was underwent gauze packing while observation group were packing gauze joint with improved uterine suture Cho, the two groups were observed therapeutic effects and complications. Results： The total efficiency of observation group is 93.02%, and the total efficiency of the control group is 62.79%, there is a significant better treatment effect for observed group than the control group （P 〈0.05）, and complication rate of observation group is significantly lower than the control group （P 〈0.05）. Conclusions： In refractory postpartum hemorrhage intervention therapy, the use of gauze packing combined with modified suture uterus Cho has better clinical treatment effect with high security, so it is worthy of clinical application.

OBSERVATION ON THE THERAPEUTIC EFFECT OF BIRD-PECKING MOXIBUSTION OF SPECIFIC ACUPOINTS IN THE TREATMENT OF FUNCTIONAL DYSPEPSIA

Objective: To observe the therapeutic effect of moxibustion of some specific acupoints for treatment of functional dyspepsia (FD, qi-distension type). Methods:A total of 50 cases of FD patients were randomly divided into treatment group (n=26) and medication group (n=24). In treatment group, bird-pecking moxibustion was applied to Zhongwan (CV 12), Qihai (CV 6), Neiguan (PC 6) and Gongsun (SP 4) 5～6 times in every treatment till the local skin got flush. The treatment was given once daily, continuously for 10 days. In control group, the patients were ordered to take Motilium 10 mg/time, 3 times daily. Following 10 days’ treatment the therapeutic effect was assessed.Results:After treatment, of the 26 cases in treatment group, 11 (42.3%) were cured, 7 (26.92%) had remarkable improvement in their symptoms, 6 (23.07%) had improvement and 2 (7.69%) failed, with a total effective rate of 92.31%. Of the 24 cases in medication group, 9 (37.50%) were cured, 6 (25.00%) experienced remarkable improvement in their symptoms, 6 (25.00%) were improved and 3 (12.50%) failed, with a total effective rate of 87.50%. Comparison between two groups showed that the therapeutic effect of moxibustion was significantly superior to that of medication (P<0.05). In addition, the difference value of the therapeutic effect index (TEI) between post-and pre-treatment in treatment group was also significantly higher than that of medication group (P<0.05). Conclusion: Bird-pecking moxibustion of specific acupoints can effectively improve clinical symptoms of FD patients.

Clinical Analysis of 30 Cases of Deep Lamellar Keratoplasty for the Treatment of Corneal Disease

purpose： to analyze clinical therapeutic effect of deep lamellar keratoplasty on treatment of corneal disease. Method： select 30 cases of corneal disease patients with a total of sick eyes, from 2012 January to 2013 January; all patients underwent deep lamellar keratoplasty, then observe and analyze visual acuity, corneal and occurrence of complications, to comprehensively assess the clinical therapeutic effect. Result： after receiving treatment of deep lamellar keratoplasty, of the 30 patients and 40 eyes, 31 corneal grafts are transparent; 9 corneal grafts are translucent; postoperative visual acuity： I0 eyes are 0.01-0.04; 13 eyes are 0.05~0.1; 14 eyes are 0.1-0.4; 3 eyes are above 0.5; 10 eyes have descemet micro-perforation or small perforation; 7 eyes have complications; these conditions are all controlled after active treatment. Conclusion： for patients with corneal disease, deep lamellar keratoplasty can not only achieve the similar transparency and visual rehabilitation as penetrating keratoplasty, but also reduce the incidence of adverse reactions and reject reaction after operation, to achieve the purpose of treatment and vision improvement; it has significant clinical effect, and greatly improve the quality of patients＇ life, so it is worthy of clinical application.

Cervical Spondylosis Treated by Acupuncture at Ligou(LR 5) Combined with Movement Therapy

Objective:To compare therapeutic effects of acupuncture at Ligou(LR 5) plus movement therapy and conventional acupuncture on cervical spondylosis.Methods:The therapeutic effect of acupuncture at Ligou(LR 5) plus movement therapy on 57 cases of cervical spondylosis(Group Acup.+M) was observed and compared with that of conventional acupuncture(Group Acup.) on 65 cases of cervical spondylosis with the same types of the disease during the same observation period as those treated by the former therapy.Results:The cured rate,effective rate and total effective rate were 52.63%,45.61% and 98.24%,respectively in Group Acup.+M;46.15%,50.77% and 96.92%,respectively in Group Acup.There were no significant differences in therapeutic effects between the two groups,shown by Ridit test(P>0.05).Conclusion:Both acupuncture plus movement therapy and conventional acupuncture were similarly effective in treating cervical spondylosis,but the former was superior to the latter in shorter treatment course and fewer points used.

Clinical observation on effect of scalp electroacupuncture for mild cognitive impairment

OBJECTIVE: To evaluate the therapeutic effect of scalp electroacupuncture for mild cognitive impairment (MCI) in the early stage. METHODS: Two hundred and thirty three MCI patients were randomly divided into three groups: the drug group, the scalp electroacupuncture group, and the syndrome differentiation group. For the scalp electroacupuncture group, the points of Baihui (DU 20), Sishecong (EX-HN1), Fengchi (GB 20), and Shenting (DU 24) were selected. For the syndrome differentiation group, specific acupoints were added on the basis of syndrome differentiation and according to the scale for the differentiation of syndromes in vascular dementia (SDSVD) beside the acupoints used in the scalp electroacupuncture group. For the drug group, nimodipine was orally administered. Each patient was treated for two courses, eight weeks. The score differences in minimental state examination (MMSE), picture recognition, and clock drawing test were observed before and after the treatment. RESULTS: After treatment, the score differences in MMSE and clock drawing test were of obvious statistical significance among three groups (P<0.01, P<0.05). The score differences in picture recognition were of extremely statistical significance between the scalp electroacupuncture group and the syndrome differentiation group (P<0.01), while the difference was not found in the drug group (P>0.05). There were statistical significant differences in therapeutic effects between the scalp electroacupuncture group and the drug group, and between the syndrome differentiation group and the drug group (P<0.05), while no statistical difference was found between scalp electroacupuncture group and the syndrome differentiation group (P>0.05). CONCLUSION: All the three therapies may improve the cognitive function of MCI patients. The therapeutic effects in the scalp electroacupuncture and syndrome differentiation groups were basically the same, but superior to nimodipine.

Therapeutic evaluation of lumbar tender point deep massage for chronic non-specific low back pain

OBJECTIVE:To observe the therapeutic effect of lumbar tender point deep tissue massage plus lumbar traction on chronic non-specific low back pain using change in pressure pain threshold,muscle hardness and pain intensity as indices.METHODS:We randomly divided 64 patients into a treatment group(32 cases) and a control group(32 cases).Two drop-outs occurred in each group.Patients in the treatment group received tender point deep tissue massage plus lumbar traction and patients in the control group received lumbar traction,alone.We used a tissue hardness meter/algometer and visual analog scale(VAS) to assess the pressure pain threshold,muscle hardness and pain intensity.RESULTS:Following treatment,we obtained the following results in the treatment and control groups,respectively:the pressure pain threshold difference was 1.5±0.8 and 1.1±0.7;the muscle hardness difference was 4.2±1.6 and 3.5±1.3;and the VAS score difference was 1.9±0.9 and 1.4±0.8.Compared to the control group,the treatment group had higher pressure pain threshold(t=2.09,P<0.05),and lower muscle hardness(t=2.05,P<0.05) and pain intensity(t=2.46,P<0.05).CONCLUSION:Lumbar tender point deep tissue massage combined with lumbar traction produced better improvement in pressure pain threshold,muscle hardness and pain intensity in patients with chronic non-specific low back pain than with lumbar traction alone.

Observation on Therapeutic Effect of Mild Moxibustion plus Acupoint Injection for Optic Atrophy

Objective： To observe the clinical effect of mild moxibustion plus acupoint injection for optic atrophy. Methods： Ninety-four patients with optic atrophy were divided into a treatment group （51 cases） and a control group （43 cases）. The treatment group was treated with mild moxibustion plus acupoint injection, and the control group was treated with medications. After three courses, the change of vision was observed. Results： The total effective rate was 82.4% in the treatment group and 41.9% in the control group, with a statistical difference between the two groups （P〈O.05）. Conclusion： Moxibustion plus acupoint injection is an effective method to treat optic atrophy.

Clinical Effects of Acupuncture for Diabetic Peripheral Neuropathy

Objective:To observe the clinical effects of acupuncture for diabetic peripheral neuropathy.Methods:Totally 65 patients were randomly divided into a treatment group of 32 cases and a control group of 33 cases. On the basis of conventional treatment of diabetes,acupuncture was used in the treatment group,and inositol was orally administered in the control group.During a 3-month treatment,changes in the symptoms were observed.Results:In the treatment group,16 cases were markedly relieved,12 cases improved,and 4 cases failed,with a total effective rate of 87.5%.In the control group,7 cases were markedly relieved,14 cases improved and 12 cases failed,with a total effective rate of 63.6%.There was a significant difference in the total effective rate between the 2 groups(P<0.05) .Conclusion:Acupuncture may show good effects for diabetic peripheral neuropathy.

44 Cases of Peripheral Facial Paralysis Treated by the SXDZ-100 Nerve and Muscle Stimulator

Objective: To observe the clinical effects of the Hua Tuo Manual Acupuncture Therapeutic Stimulator for peripheral facial paralysis. Methods: 87 patients with peripheral facial paralysis were divided randomly into the SXDZ-100 Nerve and Muscle Stimulator treatment group (44 cases) and the G6805 Electric Stimulator control group (43 cases). The acupoints selected for both the two groups were local points as well as distal points as Hegu (LI 4), Waiguan (TE 5), Sanyinjiao (SP 6), Taichong (LR 3). Effectiveness was compared between the two groups. Results: Both groups had a total effective rate of 100%. But the cure rate was 90.9% in the treatment group, and 73.0% in the control group, indicating a significant difference (P<0.05). No side effects were found in either of the two groups. Conclusion: The SXDZ-100 stimulator is more effective than the G6805 electroacupuncture stimulator for treatment of peripheral facial paralysis.

Clinical effect of Sidong Wubu method in treatment of closed fracture of upper limbs

OBJECTIVE:To objectively evaluate the clinically curative effect of sidong wubu method on closed fracture of upper limbs.METHODS:A single-blind randomized controlled trial was used to divide 654 patients with closed fracture of upper limbs at early stage into two groups.298 patients in the surgical group were treated with open reduction and internal fixation and 356 patients in the treatment group with sidong wubu method for 6 months as a course of treatment.RESULTS:As for short-term curative effect(after 6 courses of treatment),the total effective rate was 97.7% in the treatment group and 92.9% in the control group,and the excellent and good rate was 83.7% and 76.5% respectively.Fracture-healing time,treatment cost,function-recovering time,scores of symptoms and signs obviously declined in both groups with remarkable difference between the two groups.As to long-term curative effect(after follow-up visit for one year to 5 years and 2 months),there was still noticeable difference(χ 2 = 7.536,P<0.05) in total curative effect and in excellent and good rate between the two groups.CONCLUSION:With low cost,short treatment course,good function and other advantages,sidong wubu method can be first used to treat closed fracture of upper limbs.

Sixty-eight Cases of Child Chronic Cough Treated by Moxibustion

Objective: To observe the therapeutic effects of moxibustion for chronic cough in children. Methods: 68 child cases of chronic cough were treated by moxibustion. Results: 54 cases were cured, 13 cases improved, and one case failed. The cure rate was 79.2%, with a total effective rate of 98.5%. Conclusion: The moxibustion therapy has definite therapeutic effect for children chronic cough.