Personal Experience in TCM Treatment of Reflux Esophagitis

Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus.

Clinical effects of psychological intervention and drug therapy against peptic ulcer

Objective:To evaluate the clinical effects of psychological interventions and drug therapy against peptic ulcer.Methods:96 patients with peptic ulcer were divided into control group with Tagamet 800 mg per evening p.o.and trial group with psychological intervention on the basis of drug treatment.Results:There were significant differences between the two groups(P【0.05), the trial group showed that the anxiety and depression cases declined obviously and effective rate of ulcer therapy was much higlier than control group.Conclusions:In sum,psychological intervention combined with drug therapy provides an effective method for ulcer treatment.

Role of deubiquitinase JOSD2 in the pathogenesis of esophageal squamous cell carcinoma

BACKGROUND Esophageal squamous cell carcinoma(ESCC)is a deadly malignancy with limited treatment options.Deubiquitinases(DUBs)have been confirmed to play a crucial role in the development of malignant tumors.JOSD2 is a DUB involved in con-trolling protein deubiquitination and influencing critical cellular processes in cancer.AIM To investigate the impact of JOSD2 on the progression of ESCC.METHODS Bioinformatic analyses were employed to explore the expression,prognosis,and enriched pathways associated with JOSD2 in ESCC.Lentiviral transduction was utilized to manipulate JOSD2 expression in ESCC cell lines(KYSE30 and RESULTS )Preliminary research indicated that JOSD2 was highly expressed in ESCC tissues,which was associated with poor prognosis.Further analysis demonstrated that JOSD2 was upregulated in ESCC cell lines compared to normal esophageal cells.JOSD2 knockdown inhibited ESCC cell activity,including proliferation and colony-forming ability.Moreover,JOSD2 knockdown decreased the drug resistance and migration of ESCC cells,while JOSD2 overexpression enhanced these phenotypes.In vivo xenograft assays further confirmed that JOSD2 promoted tumor proliferation and drug resistance in ESCC.Mechanistically,JOSD2 appears to activate the MAPK/ERK and PI3K/AKT signaling pathways.Mass spectrometry was used to identify crucial substrate proteins that interact with JOSD2,which identified the four primary proteins that bind to JOSD2,namely USP47,IGKV2D-29,HSP90AB1,and PRMT5.CONCLUSION JOSD2 plays a crucial role in enhancing the proliferation,migration,and drug resistance of ESCC,suggesting that JOSD2 is a potential therapeutic target in ESCC.

Therapeutic Effect Observation on Combined Acupuncture and Chinese Medicine for Reflux Esophagitis

Objective：To observe the clinical effect of combined acupuncture and Chinese medicine for reflux esophagitis.Methods：120 cases with reflux esophagitis were randomly allocated into 4 groups,30 in each group,a group of combined acupuncture and Chinese medicine,a group of Chinese medicine,a group of acupuncture and agroup of Westem medication（Omeprazole Enteric-coated Capsules）.Cases in the four groups were treated 60 d as one course of treatment.The plasma gastrin and motilin levels in all groups were measured before and one course after treatment for effect evaluafion.Results：There were no inter-group statistical differences of plasma gastrin and motilin levels before treatment.The plasma gastrin and motilin levels in all groups were significantly elevated after treatment（P〈0.01）.The group of combined acupuncture and Chinese medicine showed a significantly higher level than the Western medication and Chinese medicine group （P〈0.05）.Conclusion：Combined acupuncture and Chinese medicine can remarkably elevate the plasma gastrin and motilin levels in those with reflux esophagitis,regulate the gaslro-esophagus motility,increase the lower esophageal sphincter pressure and thus prevent regurgitation of food.

A Randomized Clinical Study on Combination of Concurrent Chemo-Radiotherapy and Thalidomide for Middle-Late Esophageal Cancer

OBJECTIVE To evaluate the response rate and tolerance of patients with middle-late esophageal carcinoma, who were treated with concurrent chemoradiotherapy （CCRT） plus thalidomide.METHODS Sixty-five eligible patients with local middle-late esophageal carcinoma were randomly assigned to the treatment group （TG） and the control group （CG）. The 33 patients from the TG were treated with CCRT plus thalidomide （a 60-70 Gy of radiation dose, and 5-FU plus cisplatin; oral administration of thalidomide at a dose of 100 mg/d on the first week and 200 mg/d on the second. Both were taken with water, at bedtime until completion of the radiotherapy. In the CG, 32 patients received CCRT only. The clinical effects and tolerance to the CCRT between the 2 groups were compared.RESULTS The response rates of the therapeutic combination in the TG and CG were 87.9% and 68.7%, respectively. There were no statistical differences in comparing the response rates between the 2 groups （P 〉 0.05）; the local control rates in the TG and CG were 93% and 91%, respectively, and there were no statistical differences between the 2 groups （P 〉 0.05）; the 1-year survival rates of the patients in the TG and CG were 74.0% and 63.0%, respectively, without statistical differences between the 2 groups （P 〉 0.05）. The improvement rates of KPS scoring in the TG and CG were 57.6% and 31.3%, respectively. There were significant differences in comparing the improvement rates between the 2 groups （P 〈 0.05）. The incidence rates of nausea and vomiting were lower in the TG compared to the CG, with a statistical significance between the 2 groups （P 〈 0.05）. However, the incidence rates of constipation, lethargy and fatigue were higher in the TG than in CG, showing a statistically significant difference between the 2 groups （P 〈 0.05）. CONCLUSION CCRT combined with thalidomide in treating esophageal carcinoma may improve the quality of life of the patients, the treatment may also raise patients＇ compliance to chemoradiotherapy, and possibly increase their long-term survival rate. Further studies related to this topic are needed.

黄连素+四联疗法治疗幽门螺杆菌阳性消化性溃疡的临床效果分析

目的探究黄连素(别称:盐酸小檗碱)与四联疗法联合用药方案治疗幽门螺杆菌(Hp)阳性消化性溃疡的临床效果,为临床医师选择合理用药方案提供参考。方法204例Hp阳性消化性溃疡患者为研究对象,采用随机数字表法分为对照组和观察组,每组102例。对照组患者接受常规四联疗法治疗,观察组采用黄连素与四联疗法联合治疗。比较两组患者症状改善时间、Hp清除率及复发率、临床治疗效果、不良反应发生率。结果观察组患者反酸、嗳气、腹痛消失时间与溃疡愈合时间分别为(2.95±0.51)、(3.85±0.44)、(5.65±0.88)、(8.74±0.85)d,较对照组的(4.35±0.85)、(6.85±0.61)、(7.51±1.38)、(12.45±1.28)d短(P<0.05)。观察组患者Hp清除率及复发率分别为96.1%、3.9%,对照组患者分别为80.4%、17.6%,两组比较,观察组患者Hp清除率高,复发率低(P<0.05)。观察组患者治疗总有效率为98.0%,对照组为90.2%,两组比较,观察组较高(P<0.05)。观察组患者不良反应发生率为2.0%(2/102),与对照组的3.9%(4/102)比较无差异(P>0.05)。结论对Hp阳性消化性溃疡患者实施四联疗法治疗时联合黄连素可以快速改善临床症状,提升治疗效果,同时还能提高Hp清除率,降低复发率,值得推广。

伊托必利联合雷贝拉唑治疗反流性食管炎的效果研究

目的探讨伊托必利联合雷贝拉唑治疗反流性食管炎的效果。方法130例反流性食管炎患者,经随机数字分类法分为非依托组与加依托组,各65例。非依托组患者采用雷贝拉唑治疗,加依托组在非依托组基础上增加伊托必利治疗。比较两组症状消退时间、临床疗效、食管动力学指标及不良反应发生率。结果加依托组总有效率96.92%(63/65)显著高于非依托组的75.38%(49/65)(P<0.05)。加依托组反酸烧心、腹胀、嗳气、胃脘疼痛、恶心呕吐消退时间分别为(7.93±1.26)、(8.12±1.24)、(7.24±1.38)、(6.52±1.13)、(5.93±1.54)d,均显著短于非依托组的(10.58±1.35)、(11.25±2.37)、(12.52±3.05)、(9.54±1.52)、(9.46±1.75)d(P<0.05)。治疗后,加依托组立位反流时间百分比(1.86±0.45)%、卧位反流时间百分比(2.71±0.95)%及总反流时间百分比(4.65±1.37)%均显著低于非依托组的(4.52±1.63)%、(5.47±1.38)%、(10.56±3.28)%,食管括约肌压力(4.58±0.52)kPa显著高于非依托组的(2.63±0.25)kPa(P<0.05)。加依托组用药后不良反应发生率12.31%(8/65)与非依托组的9.23%(6/65)比较,差异无统计学意义(P>0.05)。结论在雷贝拉唑抑酸治疗基础上联合伊托必利治疗,可有效促进反流性食管炎患者食管黏膜病变复常,改善患者食管动力学指标与临床症状,缩短患者病程,提升临床疗效,且安全可靠。

Metastases of esophageal carcinoma to skeletal muscle:Single center experience

Metastases of esophageal carcinoma to the skeletal muscle are rare,but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography(PET/CT).A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases.Four patients had skeletal muscle metastases of esophageal carcinoma,including two patients with squamous cell carcinoma.In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases,muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma.In all cases,skeletal muscle metastases were the first manifestation of systemic disease.In three patients palliation was obtained with the combination of external beam radiation therapy,systemic chemotherapy or surgical resection.Skeletal muscle metastases are a rare complication of esophageal carcinoma.

Esophageal tuberculosis complicated with intestinal tuberculosis: A case report

BACKGROUND Although the overall incidence of tuberculosis in underdeveloped areas has increased in recent years, esophageal tuberculosis(ET) is still rare. Intestinal tuberculosis(ITB) is relatively more common, but there are few reports of ET complicated with ITB. We report a case of secondary ET complicated with ITB in a previously healthy patient.CASE SUMMARY A 27-year-old female was hospitalized for progressive dysphagia, retrosternal pain, acid regurgitation, belching, heartburn, and nausea. Upper gastrointestinal endoscopy showed a mid-esophageal ulcerative hyperplastic lesion. Endoscopic ultrasonography showed a homogeneous hypoechoic lesion, with adjacent enlarged lymph nodes. Biopsy histopathology showed inflammatory exudation,exfoliated epithelial cells and interstitial granulation tissue proliferation.Colonoscopy revealed a rat-bite ulcer in the terminal ileum and a superficial ulcer in the ascending colon, near the ileocecal region. The ileum lesion biopsy showed focal granulomas with caseous necrosis. Polymerase chain reaction for Mycobacterium tuberculosis was positive in the esophageal and ileum lesion biopsies. The T-cell spot tuberculosis test was also positive. The patient was diagnosed with secondary ET infiltrated by mediastinal lymphadenopathy and complicated with ITB, possibly from the Mycobacterium tuberculosis-infected esophageal lesion. After 2 mo of anti-tuberculosis therapy, her symptoms improved significantly, and upper gastrointestinal endoscopy showed healing ulcers.CONCLUSION When dysphagia or odynophagia occurs in patients at high-risk for tuberculosis,ET should be considered.

连续性药学服务对鼻饲肠内营养食管癌患者用药相关问题和依从性的影响

目的 探讨连续性药学服务对鼻饲肠内营养的食管癌患者用药相关问题和依从性的影响。方法 选取2022年4-9月江苏省肿瘤医院食管癌术后鼻饲肠内营养患者,构建并实施连续性药学服务流程,采用欧洲医药保健网(PCNE)分类系统和Morisky调查问卷,评价药学服务前后用药相关问题(DRPs)和用药依从性,探讨连续性药学服务价值。结果 共纳入52例食管癌术后鼻饲肠内营养的住院患者,其中48例患者入院时存在DRPs(共计78个),包括58个治疗有效性DRPs、8个安全性DRPs和12个不必要的药物治疗DRPs。实施连续性药学服务后,存在DRPs患者例数减少[22(42.31%)vs.48(92.30%),P<0.05],DRPs类型较入院时减少,其中治疗有效性、不必要的药物治疗较为明显;第1次回访时用药依从性评分显著高于入院时[(3.44±0.40)vs.(2.65±1.24),P<0.05],第2次回访时(3.87±0.40)显著高于入院时和第1次回访时(P<0.05)。结论 接受鼻饲肠内营养的食管癌患者发生DRPs的数量和类型较多,通过构建并实施连续性药学服务,可减少DRPs发生,提高用药依从性。

伴有无效食管运动的胃食管反流病诊疗进展

无效食管运动是一种在胃食管反流病中十分常见的食管动力障碍,该文介绍了伴有无效食管运动的胃食管反流病的两者关系、酸反流及动力特点、临床症状、药物治疗和手术治疗,揭示了无效食管运动导致胃食管反流病的机制、发展过程及表现,并且指出无效食管运动的存在并非胃食管反流病的手术禁忌证。

西黄胶囊辅助晚期肺癌、贲门/食管癌患者化疗的疗效分析

目的 探讨西黄胶囊辅助晚期肺癌、贲门/食管癌化疗的治疗效果。方法 选取2017年5月1日至2022年5月1日在安徽医科大学第三附属医院治疗的101例晚期肺癌、贲门/食管癌患者按是否使用西黄胶囊分为2组。对照组47例,采用常规方案化疗;观察组54例,采用西黄胶囊联合常规方案化疗;比较2组患者的临床疗效、免疫功能和不良反应。结果 观察组治疗有效率为92.5%;对照组治疗有效率为74.4%,2组差异有统计学意义(P<0.05)。观察组在治疗效果上明显优于对照组。观察组发生不良反应9例(16.6%),对照组发生不良反应18例(38.3%),2组差异有统计学意义(P<0.05)。治疗后,观察组的CD3^(+)、CD4^(+)、CD8^(+)的水平明显高于对照组,差异均有统计学意义(P<0.05)。结论 西黄胶囊对晚期的肺癌、食管/贲门癌化疗具有良好的辅助治疗效果,可有效减少化疗药物的不良反应,增强患者的免疫功能。

铂基光热药物载体对人食管癌细胞的作用研究

目的探讨不同浓度铂基纳米药物载体的近红外光热性能及其光热疗法抗肿瘤作用。方法利用热溶剂法制备具有近红外光吸收特性的铂基纳米药物载体,系统研究其形貌、粒径、表面电荷等理化性能,考察其在980 nm处的近红外吸光特性及循环产热性能,调查其对人食管鳞状细胞癌细胞TE-1的光热杀伤效果,并采用variance(ANOVA)方差分析和独立样本t检验进行统计。结果铂基纳米载体具有较强的近红外光吸收特性(OD=1.28)、近50℃的光热转换性能以及>95%的光热消融Te-1肿瘤细胞的能力。结论铂基纳米载体介导的光热疗法具有潜的临床治疗应用价值。

紫杉醇治疗食管癌疗效分析

目的：观察国产紫杉醇（紫素，ＴＡＸ）单药、与顺铂和５氟尿嘧啶联合治疗食管癌的疗效。方法：用从我国红豆杉中提取的ＴＡＸ治疗Ⅲ、Ⅳ期食管癌。单药治疗食管癌：ＴＡＸ１５０～１７５ｍｇ／ｍ２，静滴３小时，每３周一次，共２周期。ＴＡＸ／ＤＤＰ／５ＦＵ联合化疗：ＴＡＸ１３５ｍｇ／ｍ２，ｉｖ；ＤＤＰ每天２５ｍｇ／ｍ２，第１～３天静滴；５ＦＵ每天５００～７５０ｍｇ／ｍ２，第１～５天静滴。同期内用ＤＤＰ／５ＦＵ方案：ＤＤＰ每天２５ｍｇ／ｍ２，第１～３天静滴，５ＦＵ每天５００～７５０ｍｇ／ｍ２，第１～５天静滴。联合化疗每２８天重复为一周期，２～３周期为一疗程。结果：紫杉醇单药化疗有效率３３３％（３／９）；ＴＡＸ／ＤＤＰ／５ＦＵ治疗３０例食管癌的有效率为７７％（２３／３０）；ＤＤＰ／５ＦＵ治疗食管癌４５例，有效率为５３％（２４／４５）。前一联合方案的总有效率高于后者（Ｐ＜００５），不良反应也较后者重，但大多数患者能耐受。结论：紫杉醇是治疗食管癌的有效单药，与ＤＤＰ／５ＦＵ方案联用能明显提高疗效。

多西他赛联合顺铂同期放化疗治疗食管癌术后复发转移的临床观察

目的：观察多西他赛加顺铂化疗配合放疗治疗食管癌术后复发转移的近期疗效及毒副反应。方法：化疗方案：多西他赛75mg／m^2，静脉滴入，d1；顺铂80mg／m^2，静脉滴入，d1～d3，3周重复；总化疗105个周期，平均每例2．5个周期。放疗方法：采用针对转移灶小野照射，中位总剂量60C-y／（30次·6周）。放疗于第1个周期化疗结束后第2天进行。结果：42例术后复发转移食管鳞癌患者，应用化疗加放疗治疗后，CR11例（26．2％），PR22例（52．4％），NC6例（14．3％），PD3例（7．1％），总有效率（CR＋PR）为78．6％。中位缓解期7．3个月，中位生存期14．8个月，半年、1年的生存率分别为89．6％和67．1％。主要剂量限制性毒副反应为Ⅱ、Ⅲ级白细胞下降（42．9％）和放射性气管炎（36．1％）。结论：多西他赛加顺铂化疗配合放疗治疗食管癌术后复发转移的毒副反应轻，患者能够耐受，近期疗效可靠，值得临床进一步研究。

多西他赛联合顺铂治疗晚期食管癌临床观察

为了观察多西他赛联合顺铂(DDP)化疗方案治疗晚期食管癌的近期疗效和不良反应,制定化疗方案如下:多西他赛60mg/m2,静脉滴入1h,d1;DDP30mg/m2,静脉滴入,d2～d4。21d为1个周期,完成3个周期后判定疗效。全组病例110例:初治78例有效率46%(36/78),复治32例,有效率25%(8/32),总有效率40%(44/110)。主要毒副反应为恶心、呕吐和骨髓抑制。初步研究结果提示,多西他赛联合DDP是治疗晚期食管癌有效且毒性较少的联合化疗方案。

同步放化疗结合中医扶正治疗食管癌的临床研究

127例食管癌患者随机分为单放组(RT组51例)、放化组(CRT组30例)和适形放疗加化疗结合中医扶正组(三联组46例)。单放组采用常规三野等中心放射治疗;放化组自常规放疗开始后第1、5周加用化疗;三联组采用适形放疗,自放疗开始后第1、5周加用化疗,同时放疗期间每日服用扶正升血煎剂。随访至2005年6月,单放组、放化组及三联组的骨髓抑制发生率分别为25.5%、90%和54.3%;急性放射性食管炎发生率分别为94.1%、96.7%和21.7%;放射性肺炎发生率分别为11.8%、26.7%和4%;完全缓解率分别为39.2%、66.7%和84.8%,部分缓解率分别为60.8%、33.3%和15.2%;1年生存率分别为43.1%、50%和71.7%;2年生存率分别为33.3%、40%和56.5%;3年生存率分别为13.7%、27%和39.1%。初步研究结果提示,适形放疗加化疗结合中医扶正治疗食管癌在提高患者生存质量、近期疗效及短期生存率方面明显优于单纯放疗及放化结合治疗,而且毒副反应较小。

灭Hp胶囊与新三联并用对溃疡愈合质量及溃疡复发的影响

目的 观察灭Hp胶囊与新三联并用对消化性溃疡的溃疡愈合质量及溃疡复发的影响。方法 75例活动期消化性溃疡并Hp阳性患者随机分为 3组 :A组 (新三联组 ) :口服兰索拉唑 30mg (1次 /d) +克拉霉素 2 5 0mg(2次 /d) +阿莫西林 5 0 0mg (2次 /d) ,连用 10d ;B组 (灭Hp胶囊四联组 ) :口服新三联 +灭Hp胶囊 6粒 (2次 /d) ,连用 2 8d;C组 (安慰剂组 ) :口服胃舒平 3片 (2次 /d) ,连用 2 8d。疗程结束后 4周复查胃镜 ,观察Hp根治和溃疡愈合情况 ,对溃疡愈合者行光镜及电镜检查 ,评价溃疡愈合质量 ,并停服所有药物 ,随访 5年。结果 A、B两组患者溃疡愈合率、Hp根治率分别为 10 0 0 %、 96 4 % ,88 0 %、 92 0 % ;与安慰剂组的溃疡愈合率 (2 0 0 % )、Hp根治率 (0 )间差别均有显著性意义 (P <0 0 0 5 )。A、B两组与C组的溃疡愈合质量间的差别亦有显著性意义 (P <0 0 5 )。A组和B组溃疡复发率分别为 4 0 %和 10 0 % ,明显低于安慰剂的溃疡复发率 (10 0 % ) ,溃疡复发者均溃疡愈合质量不佳。结论 灭Hp胶囊四联疗法不但具有与新三联相当的Hp根治率和溃疡愈合率 ,而且更有显著提高溃疡愈合质量。

后程加速超分割适形放疗加同步化疗治疗食管癌的临床观察

目的:比较后程加速超分割适形放疗(简称适形放疗)和适形放疗加同步化疗治疗食管癌的疗效与毒副反应。方法:将无远处转移的62例初治食管鳞癌患者随机分成适形放疗组和适形放疗协同化疗组(简称综合组)。适形放疗组:先行放疗41.4Gy/(23次.5周),后行放疗27Gy/(18次.2周);综合组:放射治疗方法同适形放疗组,只是在放射治疗的开始时同期均加用2个周期化疗(5-FU 0.75g,静脉滴入,1次/d,d1~d5;DDP 40mg,静脉滴入,1次/d,d1~d3),从放疗第1天开始,28d为1个周期。观察指标主要包括食管和肺的近期急性反应、后期放射损伤、血液学不良反应、1~5年局控率、无瘤生存率和总体生存率等。结果:综合组总生存率和无瘤生存率均高于适形放疗组,但差异无统计学意义,P>0.05。综合组的急性毒副反应较严重,Ⅲ级急性食管炎、骨髓抑制发生率与适形放疗组比较差异有统计学意义,P值分别为0.001和0.02。晚期并发症主要表现为食管狭窄和肺纤维化,两组比较差异无统计学意义。结论:后程加速超分割适形放疗加同步化疗治疗食管癌,患者能耐受,但其加重了急性反应,未加重远期毒副反应;能提高1~5年无瘤生存率和总体生存...

热疗联合同步放化疗治疗中晚期食管癌的临床研究

目的观察热疗联合同步放化疗治疗中晚期食管癌的近期疗效、不良反应。方法 66例不能手术或不同意手术的中晚期食管癌患者,随机分成两组,治疗组应用深部热疗联合同步放化疗,对照组应用同步放化疗,比较两组近期疗效和不良反应。结果治疗组近期疗效高于对照组,差异有统计学意义(P<0.05);治疗组在骨髓抑制、胃肠道反应及放射性食管炎发生率方面均低于对照组,差异有统计学意义(P<0.05)。结论热疗联合同步放化疗治疗中晚期食管癌疗效优于同步放化疗,并且降低了放化疗的不良反应,值得进一步探讨。