BACKGROUND Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors,often diagnosed in an advanced stage when curative treatment is impossible and grueling symptoms related to vasoactive substance rele...BACKGROUND Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors,often diagnosed in an advanced stage when curative treatment is impossible and grueling symptoms related to vasoactive substance release by tumor cells affect patients’quality of life.Cardiovascular complications of GEP-NENs,primarily tricuspid and pulmonary valve disease,and right-sided heart failure,are the leading cause of death,even compared to metastatic disease.CASE SUMMARY We present a case of a 35-year-old patient with progressive dyspnea,back pain,polyneuropathic leg pain,and nocturnal diarrhea lasting for a decade before the diagnosis of neuroendocrine carcinoma of unknown primary with extensive liver metastases.During the initial presentation,serum biomarkers were not evaluated,and the patient received five cycles of doxorubicin,which he did not tolerate well,so he refused further therapy and was lost to follow-up.After 10 years,he presented to the emergency room with signs and symptoms of right-sided heart failure.Panneuroendocrine markers,serum chromogranin A,and urinary 5-hydroxyindoleacetic acid were extremely elevated(900 ng/mL and 2178µmol/L),and transabdominal ultrasound confirmed hepatic metastases.Computed tomo-graphy(CT)showed liver metastases up to 6 cm in diameter and metastases in mesenteric lymph nodes and pelvis.Furthermore,an Octreoscan showed lesions in the heart,thoracic spine,duodenum,and ascendent colon.A standard trans-thoracic echocardiogram confirmed findings of carcinoid heart disease.The patient was not a candidate for valve replacement.He started octreotide acetate treatment,and the dose escalated to 80 mg IM monthly.Although biochemical CONCLUSION Carcinoid heart disease occurs with carcinoid syndrome related to advanced neuroendocrine tumors,usually with liver metastases,which manifests as right-sided heart valve dysfunction leading to right-sided heart failure.Carcinoid heart disease and tumor burden are major prognostic factors of poor survival.Therefore,they must be actively sought by available biochemical markers and imaging techniques.Moreover,imaging techniques aiding tumor detection and staging,somatostatin receptor positron emission tomography/CT,and CT or magnetic resonance imaging,should be performed at the time of diagnosis and in 3-to 6-mo intervals to determine tumor growth rate and assess the possibility of locoregional therapy and/or palliative surgery.Valve replacement at the onset of symptoms or right ventricular dysfunction may be considered,while any delay can worsen right-sided ventricular failure.展开更多
According to the theory of traditional Chinese medicine,based on the four properties and five flavors of traditional Chinese medicines,the lifting and lowering theory and channel tropism,Professor Chen combined with t...According to the theory of traditional Chinese medicine,based on the four properties and five flavors of traditional Chinese medicines,the lifting and lowering theory and channel tropism,Professor Chen combined with the theory of traditional Chinese medicine and constitution identification to prescribe for patients and used herb pairs to treat many kinds of pulmonary diseases.And he has achieved good clinical effect by"treatment methods selection according to syndromes".His experience in medication and compatibility mechanism are worthy of further exploration and promotion by scholars.展开更多
The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study...The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study of collaterals theory by many practitioners,its advantages in differentiating and treating gynecological diseases are gradually embodied.Based on the theory of collaterals disease,we discussed the pathogenesis,syndrome differentiation and treatment of gynecological diseases,concluded that the deficient collaterals under nourishment and the stagnant and blocked uterine collateral are the important pathogenesis of gynecological illness.Then we pointed out that invigorating the spleen and tonifying the kidney,and unblocking collateral and dissipating stasis are important treatment methods.We discussed the application of collateral disease theory in Tianjin HA's gynecology,and provided certain theoretical basis and clinical reference for the treatment of gynecologic diseases.展开更多
Objective:To investigate the differential gene expression profiles in coronary heart disease(CHD) patients of blood-stasis syndrome(BSS) by oligonucleotide microarray technique,and the clinical significance of target ...Objective:To investigate the differential gene expression profiles in coronary heart disease(CHD) patients of blood-stasis syndrome(BSS) by oligonucleotide microarray technique,and the clinical significance of target gene.Methods:Subjects were assigned to CHD patients with BSS(n=8),CHD patients without BSS (n=8),and BSS patients without CHD(n=8) based on coronary angiography and the diagnostic criteria of BSS. The sex- and age-matched healthy volunteers(n=8) were enrolled as the control group.Venous blood s...展开更多
Background Phlegm and blood stasis syndrome(PBSS) is one of the main syndromes in coronary heart disease(CHD). Syndromes of Chinese medicine(CM) are lack of quantitative and easyimplementation diagnosis standards. To ...Background Phlegm and blood stasis syndrome(PBSS) is one of the main syndromes in coronary heart disease(CHD). Syndromes of Chinese medicine(CM) are lack of quantitative and easyimplementation diagnosis standards. To quantify and standardize the diagnosis of PBSS, scales are usually applied. Objective: To evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. Methods: Six hundred patients with stable angina pectoris of CHD, 300 in case group and 300 in control group, will be recruited from 5 hospitals across China. Diagnosis from 2 experts will be considered as the "gold standard". The study design consists of 2 phases: pilot test is used to evaluate the reliability and validity, and diagnostic test is used to assess the diagnostic accuracy of the scale, including sensitivity, specificity, likelihood ratio and area under the receiver operator characteristic(ROC) curve. Discussion: This study will evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. The consensus of 2 experts may not be ideal as a "gold standard", and itself still requires further study.(No. ChiCTR-OOC-15006599).展开更多
Objective:To analyse the correlation between the characteristics of coronary plaque in coronary heart disease(CHD)patients with phlegm-blood stasis syndrome(PBS)and blood stasis syndrome(BSS).Methods:Patients were div...Objective:To analyse the correlation between the characteristics of coronary plaque in coronary heart disease(CHD)patients with phlegm-blood stasis syndrome(PBS)and blood stasis syndrome(BSS).Methods:Patients were divided into different groups based on Chinese medicine(CM)syndrome differentiation.The baseline demographics and clinical variables were collected from the medical records.Additionally,the characteristics of plaque and pathological manifestations in coronary artery were evaluated intravascular ultrasound(IVUS).Results:A total of 213 CHD patients were enrolled in two groups:184 were diagnosed with PBS and the remaining 29 were diagnosed with BSS.There were no significant differences in age,body mases index,proportions of patients with high blood pressure,diabetes mellitus,smoking,hyperlipidemia,history of coronary artery bypass graft and percutaneous coronary intervention,medications,index from cardiac ultrasound image,blood lipids and C-reactive protein between the two groups(P>0.05),except gender,weight and proportions of OVUS observed target vessels(P<0.05 or P<0.01).More adverse events such as acute myocardial infarction(P=0.003)and unstable angina(P=0.048)were observed in BSS.Additionally,dissection,thrombus and coronary artery ectasia were significantly increased in BSS(P<0.05 or P<0.01).In contrast,PBS had more patients with stable angina and chronic total occlusion with significantly higher SYNTAX(synergy between percutaneous coronary intervention with Taxus and coronary artery bypass surgery)scores(P<0.05 or P<0.01).Moreover,dense-calcium was significantly elevated in PBS(P<0.01).Conclusions:Coronary plaque characteristics were correlated with different CM syndromes.Patients with PBS were associated with a higher degree of calcified plaque and severe coronary artery stenosis,indicating poor clinical prognosis but with a low probability of acute coronary events.On contrast,the degree of calcified plaque in patients with BSS remained relatively low,and plaque was more vulnerable,resulting in the possibility of the occurrence of acute coronary events remaining high.展开更多
文摘BACKGROUND Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors,often diagnosed in an advanced stage when curative treatment is impossible and grueling symptoms related to vasoactive substance release by tumor cells affect patients’quality of life.Cardiovascular complications of GEP-NENs,primarily tricuspid and pulmonary valve disease,and right-sided heart failure,are the leading cause of death,even compared to metastatic disease.CASE SUMMARY We present a case of a 35-year-old patient with progressive dyspnea,back pain,polyneuropathic leg pain,and nocturnal diarrhea lasting for a decade before the diagnosis of neuroendocrine carcinoma of unknown primary with extensive liver metastases.During the initial presentation,serum biomarkers were not evaluated,and the patient received five cycles of doxorubicin,which he did not tolerate well,so he refused further therapy and was lost to follow-up.After 10 years,he presented to the emergency room with signs and symptoms of right-sided heart failure.Panneuroendocrine markers,serum chromogranin A,and urinary 5-hydroxyindoleacetic acid were extremely elevated(900 ng/mL and 2178µmol/L),and transabdominal ultrasound confirmed hepatic metastases.Computed tomo-graphy(CT)showed liver metastases up to 6 cm in diameter and metastases in mesenteric lymph nodes and pelvis.Furthermore,an Octreoscan showed lesions in the heart,thoracic spine,duodenum,and ascendent colon.A standard trans-thoracic echocardiogram confirmed findings of carcinoid heart disease.The patient was not a candidate for valve replacement.He started octreotide acetate treatment,and the dose escalated to 80 mg IM monthly.Although biochemical CONCLUSION Carcinoid heart disease occurs with carcinoid syndrome related to advanced neuroendocrine tumors,usually with liver metastases,which manifests as right-sided heart valve dysfunction leading to right-sided heart failure.Carcinoid heart disease and tumor burden are major prognostic factors of poor survival.Therefore,they must be actively sought by available biochemical markers and imaging techniques.Moreover,imaging techniques aiding tumor detection and staging,somatostatin receptor positron emission tomography/CT,and CT or magnetic resonance imaging,should be performed at the time of diagnosis and in 3-to 6-mo intervals to determine tumor growth rate and assess the possibility of locoregional therapy and/or palliative surgery.Valve replacement at the onset of symptoms or right ventricular dysfunction may be considered,while any delay can worsen right-sided ventricular failure.
基金"Taishan scholar"construction project of Shandong Provincial People's Government(No.ts201712096)Shandong Province 2019-2020 science and technology development plan project of traditional Chinese medicine(special subject of traditional Chinese medicine classics prescription):a development project of diagnosis and treatment guide for common diseases of primary pulmonary disease department treated by traditional Chinese medicine classics prescription(No.2019-0967)。
文摘According to the theory of traditional Chinese medicine,based on the four properties and five flavors of traditional Chinese medicines,the lifting and lowering theory and channel tropism,Professor Chen combined with the theory of traditional Chinese medicine and constitution identification to prescribe for patients and used herb pairs to treat many kinds of pulmonary diseases.And he has achieved good clinical effect by"treatment methods selection according to syndromes".His experience in medication and compatibility mechanism are worthy of further exploration and promotion by scholars.
基金Tianjin Harsh Gynecology School Studio (Phase Ⅱ)(LPGZS2012-04)
文摘The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study of collaterals theory by many practitioners,its advantages in differentiating and treating gynecological diseases are gradually embodied.Based on the theory of collaterals disease,we discussed the pathogenesis,syndrome differentiation and treatment of gynecological diseases,concluded that the deficient collaterals under nourishment and the stagnant and blocked uterine collateral are the important pathogenesis of gynecological illness.Then we pointed out that invigorating the spleen and tonifying the kidney,and unblocking collateral and dissipating stasis are important treatment methods.We discussed the application of collateral disease theory in Tianjin HA's gynecology,and provided certain theoretical basis and clinical reference for the treatment of gynecologic diseases.
基金Supported by the Major Research Plan of National Natural Science Foundation of China(No.90409021)
文摘Objective:To investigate the differential gene expression profiles in coronary heart disease(CHD) patients of blood-stasis syndrome(BSS) by oligonucleotide microarray technique,and the clinical significance of target gene.Methods:Subjects were assigned to CHD patients with BSS(n=8),CHD patients without BSS (n=8),and BSS patients without CHD(n=8) based on coronary angiography and the diagnostic criteria of BSS. The sex- and age-matched healthy volunteers(n=8) were enrolled as the control group.Venous blood s...
基金Supported by National Basic Research Program of China(973 Program,No.2014CB542901)
文摘Background Phlegm and blood stasis syndrome(PBSS) is one of the main syndromes in coronary heart disease(CHD). Syndromes of Chinese medicine(CM) are lack of quantitative and easyimplementation diagnosis standards. To quantify and standardize the diagnosis of PBSS, scales are usually applied. Objective: To evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. Methods: Six hundred patients with stable angina pectoris of CHD, 300 in case group and 300 in control group, will be recruited from 5 hospitals across China. Diagnosis from 2 experts will be considered as the "gold standard". The study design consists of 2 phases: pilot test is used to evaluate the reliability and validity, and diagnostic test is used to assess the diagnostic accuracy of the scale, including sensitivity, specificity, likelihood ratio and area under the receiver operator characteristic(ROC) curve. Discussion: This study will evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. The consensus of 2 experts may not be ideal as a "gold standard", and itself still requires further study.(No. ChiCTR-OOC-15006599).
基金Supported by the National Natural Science Foundation of China(No.81774219)Guangdong Provincial Science and Technology Plan(No.201710010107)Traditional Chinese Medicine Science and Technology Research Project of Traditional Chinese Medicine Hospital of Guangdong Province(No.YN2014LN06)。
文摘Objective:To analyse the correlation between the characteristics of coronary plaque in coronary heart disease(CHD)patients with phlegm-blood stasis syndrome(PBS)and blood stasis syndrome(BSS).Methods:Patients were divided into different groups based on Chinese medicine(CM)syndrome differentiation.The baseline demographics and clinical variables were collected from the medical records.Additionally,the characteristics of plaque and pathological manifestations in coronary artery were evaluated intravascular ultrasound(IVUS).Results:A total of 213 CHD patients were enrolled in two groups:184 were diagnosed with PBS and the remaining 29 were diagnosed with BSS.There were no significant differences in age,body mases index,proportions of patients with high blood pressure,diabetes mellitus,smoking,hyperlipidemia,history of coronary artery bypass graft and percutaneous coronary intervention,medications,index from cardiac ultrasound image,blood lipids and C-reactive protein between the two groups(P>0.05),except gender,weight and proportions of OVUS observed target vessels(P<0.05 or P<0.01).More adverse events such as acute myocardial infarction(P=0.003)and unstable angina(P=0.048)were observed in BSS.Additionally,dissection,thrombus and coronary artery ectasia were significantly increased in BSS(P<0.05 or P<0.01).In contrast,PBS had more patients with stable angina and chronic total occlusion with significantly higher SYNTAX(synergy between percutaneous coronary intervention with Taxus and coronary artery bypass surgery)scores(P<0.05 or P<0.01).Moreover,dense-calcium was significantly elevated in PBS(P<0.01).Conclusions:Coronary plaque characteristics were correlated with different CM syndromes.Patients with PBS were associated with a higher degree of calcified plaque and severe coronary artery stenosis,indicating poor clinical prognosis but with a low probability of acute coronary events.On contrast,the degree of calcified plaque in patients with BSS remained relatively low,and plaque was more vulnerable,resulting in the possibility of the occurrence of acute coronary events remaining high.
