复方参鹿颗粒干预肾阳虚型骨髓增生异常综合征造血调控的临床观察

目的 评判复方参鹿颗粒对肾阳虚型骨髓增生异常综合征(MDS)(难治性贫血/难治性血细胞减少伴多系造血异常)(RA/RCMD)造血调控情况.方法 30例MDS-RA/RCMD患者随机分成复方参鹿颗粒组(简称参鹿组)(15例)和十一酸睾酮组(15例),测评治疗前后外周血象、T细胞亚群+自然杀伤(NK)细胞、骨髓细胞免疫表型.结果 参鹿组与治疗前相比,红细胞、血色素、血小板有明显上升,治疗前分别为(2.39±0.99)×1012/L、(84.47±28.68)g/L、(81.13±96.85)×109/L,治疗后分别为(2.80±0.98)×1012/L、(94.87±25.63)g/L、(98.67±107.9)×109/L,差异均有统计学意义(t=4.0359、t=2.7009、t=2.2573,均P<0.05),十一酸睾酮组仅有血红蛋白数量上升,治疗前为(71.93±27.53)g/L,治疗后为(80.07±26.03)g/L,差异有统计学意义(t=2.3125,P=0.0365);参鹿组治疗后CD+4、CD+8、CD+4/CD+8、NK细胞均达到或接近正常值,分别为(37.9±5.9)%、(24.0±5.8)%、1.75±0.83、(13.0±6.9)%,与治疗前的(29.3±11.7)%、(29.6±5.8)%、1.12±0.59、(8.8±5.7)%相比差异有统计学意义(t=2.6194、t=2.6595、t=2.6581、t=2.2288,均P<0.05),十一酸睾酮组治疗后仅CD+8、CD+4/CD+8接近正常值,分别为(22.1±7.5)%、1.50±0.74,与治疗前(26.6±7.5)%、1.18±0.55相比差异有统计学意义(t=2.2377,P=0.0420;t=2.9352,P=0.0109),治疗后,参鹿组CD+4表达率为(37.9±5.9)%,十一酸睾酮组为(30.5±12.6)%,差异有统计学意义(t=2.1738,P=0.0474);参鹿组对骨髓细胞CD+13、CD+33、CD+34、CD+64、CD+117的异常阳性表达调控能力强于安雄组(前三者u=2.76、u=3.39、u=2.85,均P<0.01,后两者u=2.17、u=2.46,均P<0.05).结论 复方参鹿颗粒能有效调控肾阳虚型MDS-RA/RCMD正常造血功能.     

Clinical and experimental studies on preventing and treating anaphylactic asthma with Zusanli point immunotherapy

We have studied on preventing and treating anaphylactic asthma with Zusanli (S36) point immunotherapy (ZPIT). Sixty-nine patients were observed. The results showed that the clinical curative effect of ZPIT was not only much higher than that of conventional desensitization therapy, but also the patients' total IgE level was reduced, anti-acarid IgE was lowered, SIgA level was raised, the absolute eosinophilic granulocyte level dropped and pulmonary function recovered. Animal experiment results showed that the ZPIT could more effectively suppress the guinea pigs' anaphylactic asthma allergized by albumin and more obviously resist the guinea pigs' bronchial spasm induced by histamine and acetylcholine than the conventional desensitization therapy and injected normal saline. The immunomodulating action of the ZPIT are elucidated from clinical study and animal experiment in the paper.     

Clinical and experimental study of shengxue syrup in treating chronic aplastic anemia

The Shengxue Syrup (SXS) composed of Chinese medicinal herbs for invigorating the function of Spleen and resplenishing the Kidney was used in treating 115 chronic aplastic anemia patients. The SXS group consisted of 67 patients. After the median 20 months treatment the total effective rate (TER) was 97.0%. The other group was SXS + testosterone group consisted of 48 patients. After median 17.5 month treatment the TER was 95.8%. The difference of TER between two groups was insignificant. The result of animal experiment showed that SXS could markedly enhance the hematopoietic stem cells as well as progenitor cells proliferation of bone marrow in mice.     

Clinical observation of oral cefuroxime axetil for treating acute gonorrhoea

The effectiveness of a single oral dose of Zinnat (cefuroxime axitil) in treating acute gonorrhoea was assessed in 12 men and 2 women who received 1.0 g. the cure rate was 85.7% (12/14). No adverse effect was found. Zinnat was effective, convenient, well tolerated and valuable drug in treatment of acute gonorrhoea.     

Clinical and experimental studies on composite divitriol infusion in treating tinea manum

OBJECTIVE: To investigate the effect of Composite Divitriol Infusion (CDI) in treating tinea manum and studying its antimycotic action. METHODS: CDI was used to treat 139 patients with tinea manum. The experimental study in vivo was done, scanning electron microscopy (SEM) was used to observe the therapeutical effect of CDI. RESULTS: One hundred and four cases among the 139 patients were cured, 21 were markedly effective, 10 improved and 4 ineffective, the effective rate being 89.9%. Between CDI group and the control group, there was a very significant difference (chi 2 > 12.84, P < 0.005). The antimycotic action of CDI was studied in vitro. Its minimum inhibitory concentrations (MIC) of CDI were about 0.25% for Trichophyton rubrum, and 0.5% for Trichophyton gypseum and Microsporum gypseum. Trichophyton rubrum immersed with CDI show that the mycelia became roughened, deformed and macroconidum became smaller under SEM. CONCLUSION: CDI is valuable in treating tinea manum.     

Clinical and experimental study on bushen cong-er tablet in treating sensorineural hearing loss

According to the "Kidney has its orfice in the ear" in TCM theory, the authors adopted Bushen Cong-er tablet, a TCM preparation with the treating principles of the Kidney reinforcing and blood circulation promoting to remove stasis as well as to open up the apertures in treating 310 cases of sensorineural hearing loss. The results showed that therapeutical effect was satisfactory. The total effectve rate was 71.9%. Animal experiment also demonstrate the drug could prevent and cure the aminoglycoside antibiotic ototoxic hearing loss, could adjust the cochlear cyclic neucleotides as well as its SOD level and reduce the LPO level, raise the thyroid function and the function of sexual gland.     

Clinical and experimental study on Ligusticum wallichii mixture in preventing and treating bronchial asthma

To investigate the significance of Ligusticum wallichii Mixture (LWM) and its possible therapeutical mechanism in bronchial asthma, clinical and experimental studies were carried out. RESULTS: LWM inhibited bronchospasm induced by histamine and acetylcholine in guinea pigs; the plasma level of TXB2 was decreased remarkably and the incubation period from antigen inhalation to asthma attack could be delayed by LWM; the incidence of asthma and its mortality were reduced in guinea pigs, compared with control, P < 0.01. In addition, the prolonged period of induced asthma attack was negatively correlated to the plasma level of TXB2 in guinea pigs (P < 0.01). It was observed that the plasma level of TXB2 was decreased, the forced expiratory volume in 1 sec (FEV1%) was elevated significantly in asthmatic patients after they were treated by LWM. Moreover, the total effective rate was significantly better than that in the control (92% : 62%). It indicated that: (1) The effects of airway allergic inflammation (AAI) might be the important pathological basis for the bronchial asthma, (2) TXA2 might be an important inflammatory mediator in asthma which could be taken as an useful biochemical parameter for evaluating clinical effects, (3) LWM could relax tracheal smooth muscle, improve pulmonary function, inhibit the synthesis and release of TXA2 with no side effects.     

三维适形放疗配合腔内后装治疗宫颈癌的临床研究

Objective: The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT). Methods: Sixty cervical cancer patients were divided randomly into the conformal group and the conventional group. Thirty patients treated with 3D-conformal radiotherapy in the 3DCRT group, when the whole pelvic received DT 40 Gy, a planning CT scan of each patient was obtained and the second 3DCRT therapy plan was taken. Then, continued to irradiate to 50 Gy. At last, 3DCRT was boosted at local involved volumes to the total close of 60 Gy. When 3DCRT was combined with intracavitary brachytherapy, the dose of brachytherapy to point A was 30 Gy/5 fractions. In the conventional group, after a total tumor dose of 40 Gy was delivered by the whole pelvic irradiation, the four-field technique was used to irradiate the total pelvic and regional nodes (median close of 10 Gy), and the involved volumes were boosted to 60 Gy and the dose of brachytherapy to point A was 30 Gy-36 Gy/5-6 fractions. Moreover, both groups were combined with intracavitary brachytherapy respectively. Results: The 1, 2, 3-year survival rates for the 3DCRT group and the conventional group were 96.7%, 93.3%, 90.0% and 86.6%, 76.7%,70% respectively (P = 0.04, P = 0.02 and P = 0.02). There was a statistically significant difference between the two groups.Compared to the two groups each other in toxic effects, except for the Ⅰ-Ⅱ grade rectal and bladder reaction and pelvic fibrosis which was lower in the 3DCRT group (P = 0. 007, P = 0. 006 and P = 0. 015), the side effects were similar and well tolerated in two groups. Conclusion: The all-course 3DCRT combined with intracavitary brachytherapy can be considered as an effective and feasible approach to cervical cancer and may significantly improve the survival rate and reduce the late toxicity. This new rote for 3DCRT merits need further evaluation with large patient numbers and longer follows up.     

复方肠泰联合FOLFOX4对大肠癌术后的作用的临床观察

Objective: The aim of the study was to observe the therapeutic effect of FOLFOX4 regimen plus Fufangchangtai decoction on postoperative colorectal cancers. Methods: Thirty postoperative colorectal cancer patients were allocated into control and experiment groups respectively. Patients in experiment group were given Fufangchangtai decoction combined with FOLFOX4 regimen. Patients in control group were given FOLFOX4 regimen alone. Efficacy was evaluated after 2 periods of treatment. Results: The improvement rate of symptoms were 86.6% in experiment group compared to 53.3% in control group. KPS was stable in experiment group, and decreased in control group. QOL was increased in experiment group, and stable in control group after the treatment. For impact of immunity parameters, there were enhancements of CD3+ and CD4+ in experiment group, while they did not change in control group. In experiment group, WBC reduction was slighter than that of control group. The differences were not remarkable in PLT reduction, alimentary response, and toxicity of liver and kidney and nervous system. Conclusion: The clinical observation showed that Fufangchangtai decoction plus FOLFOX4 regimen could effectively enhance KPS, improve the symptoms, the quality of life and the immunity state, and down-regulate the side effects. In conclusion, Fufangchangtai decoction can decrease the toxicity so as to increase the treatment effect.     

颅骶疗法结合康复训练治疗中风后偏瘫性痉挛的临床研究

目的:探讨颅骶疗法结合康复训练对于中风后偏瘫痉挛状态的治疗作用.方法:60例中风后偏瘫痉挛状态的患者随机分为治疗组和对照组,治疗组采用颅骶疗法配合康复技术治疗,对照组仅用康复技术治疗.分别于治疗前和治疗后用Brunnstrom's运动功能评分法评定肌痉挛和运动功能水平.结果:治疗后两组偏瘫患者肢体痉挛及肢体运动功能均有改善,治疗组总有效率达到93.3%,对照组总有效率为73.3%,治疗组改善程度明显优于对照组(P<0.05).结论:与单纯使用康复技术相比,颅骶疗法结合康复技术对于中风偏瘫痉挛状态的康复具有更明显的促进作用.     

Clinical study on combined treatment of shuizhi tuyuan powder and nifedipine in treating hypertension patients complicated with left ventricular hypertrophy

Patients with essential hypertension complicated with left ventricular hypertrophy (LVH) confirmed by ultrasonic cardiography were divided randomly into observation group and control group. Both groups were treated with nifedipine. Shuizhi Tuyuan Powder (SZTYP, consisted of Hirudo nipponia and Eupolyphaga sinensis) was given in addition to the observation group. The therapeutic course for the two groups were 6 months. Results showed that after one course of treatment, the myocardial weight index lowered from 136.8 +/- 7.5 g/m2 to 130.5 +/- 6.4 g/m2 in observation group, while in control group, it lowered from 136.7 +/- 7.4 g/m2 to 134.3 +/- 6.2 g/m2, the difference between the two groups was significant (P < 0.01). The symptoms were relieved in part of the patients with early stage of cerebrovascular disease treated with SZTYP. The results suggested that SZTYP combined with nifedipine has active curative effect on essential hypertension patients complicated by LVH and part patients in early stage of cerebrovascular disease.     

Surgical treatment combined with radiotherapy and chemotherapy in an unselected population of patients with malignant glioma

BACKGROUND: Malignant gliomas are tumors of bad prognosis with a mean survival of 12 months. In the present report 74 patients diagnosed of malignant glioma were studied with the following aims: 1) evaluate how many could receive combined radiotherapy (RT) and chemotherapy (BCNU) treatment following surgery and 2) analyze whether the patients treated presented a survival similar to that described in the literature. METHODS: The records of 74 patients operated on for malignant glioma between 1987-1990 and consecutively included in a protocol of treatment with RT and BCNU were reviewed. RESULTS: Out of the total of 74 patients, 29 (39%) were considered evaluable. The medians of progression free interval and survival were of 10 and 16 months, respectively in these patients. Forty-five (61%) patients could not fulfill the protocol mainly because of tumoral progression prior to completion of RT and severe post surgical complications. The evaluable patients were significantly younger (p = 0.004) and tumoral exeresis wider (p = 0.0003) than in those who were not evaluable. CONCLUSIONS: Most of the patients operated on for malignant glioma may not receive treatment considered as standard, principally due to tumor progression in the first weeks following surgery and the presence of severe post surgical complications.     

食管癌全程三维适形放疗后程加速超分割的疗效观察

Objective:The aim of the study was to evaluate the therapeutic effect and safety of whole-course three-dimen-sional conformal radiotherapy (3DCRT) combined with late-course accelerated hyperfractionated radiotherapy (LCAFR) on patients with esophageal carcinoma.Methods:one hundred and one patients with esophageal carcinoma were divided into two groups.Observing group (49 cases) were treated by whole-course 3DCRT.Patients in control group (52 cases) were treated by conventional radiotherapy.Clinical efficiencies and radiation toxicities were compared between two groups.Re-sults:The side effects including radiation esophagitis (63.2%) and tracheitis (49.0%) decreased in observing group,but there was no significant difference between two groups (69.2% and 55.7% in controls).The 1-,2- and 3-year tumor local control rates and overall survival rates in the observing group were significantly improved compared with the control group,being respectively 87.8%,75.5%,63.3% vs 71.2%,55.8%,42.3% and 85.7%,71.4%,46.7% vs 69.2%,51.9%,26.9% (all P < 0.05).Conclusion:The therapeutic effect of whole-course 3DCRT combined with LCAFR for esophageal carcinomas is superior to conventional radiotherapy.     

Peculiarities of treating endocrine ophthalmopathy in patients with toxic goiter combined with diabetes mellitus

Thyroid pathology is among autoimmune diseases the incidence of which is now on the increase. Endocrine ophthalmology (EO) often accompanying thyroid disorders may cause deterioration or loss of vision. EO can be corrected by several methods. The most pronounced effect is achieved by x-ray therapy on the orbit and intermittent glucocorticosteroid (GCS) large-dose therapy. GCS, however, affect carbohydrate metabolism. In physiological levels, GCS effects on regulation of carbohydrate metabolism are not significant, but high GCS concentrations may provoke hyperglycemia and even steroid diabetes.     

卵巢切除联合依西美坦治疗绝经前激素受体阳性晚期难治性乳腺癌

Objective: Taking tamoxifen orally is the main endocrine therapy of the premenopausal breast cancer with positive hormone receptor, but numerous patients developed to be advanced refractory breast cancer because of drug resistance.Our study investigated a role of the combination of bilateral oophorectomy and exemestane in the management of advanced refractory breast cancer. Methods: The bilateral oophorectomy was carried out in 17 patients. One week after the operation,exemestane was taken orally (25 mg/d). The median time to progression (TTP), the median survival time and the survival rate were calculated using Kaplan-Meier methods. Results: Seventeen patients age ranged from 26 to 44 years (median, 36 years) were treated with an overall response rate of 64.70%, TTP was 8 months and the median survival time was 31 months.The survival rate of 1-year, 3 years and 5 years was 88.24%, 64.71%, 29.41%, respectively. There have no grade Ⅲ/Ⅳ side effects appeared. Conclusion: Bilateral oophorectomy combined with exemestane is safe and effective for advanced refractory premenopausal breast cancer with positive hormone receptor and it is well-tolerated.     

HATP chemotherapy combined with Chinese traditional medications in treating acute promyelocytic leukemia

18 patients with acute promyelocytic leukemia (APL) were treated with HATP (Harringtonine, Adriamycin, Thioguanine, Prednisone) chemotherapy combined with chinese traditional medications. These medications are known to strengthen vital energy, promote blood circulation, remove stasis and clear toxic materials. 16 patients had complete remission (88.8%) and one partial remission with a total effective rate of 94.4%. Complete remission (CR) was achieved after 3 to 4 courses of treatment in most of the cases. 14 patients were still in CR at the completion of this study and the average duration of survival was 40.5 months. With the various therapeutic actions mentioned above, the traditional medications might decrease the toxicity of chemotherapy, reduce its side effects and prevent the occurrence of DIC. The combined use of traditional medications with chemotherapy may increase the rate and duration of CR as well as prolong the survival.     

人文关怀护理在恶性肿瘤患者放疗中的效果观察

将86例行放射治疗的恶性肿瘤患者随机分为对照组40例和观察组46例,对照组行放射治疗时给予常规护理,观察组在常规护理基础上实施人文关怀护理.对两组患者放射治疗过程中紧张恐惧及抑郁情况比较分析.结果观察组患者的紧张、恐惧及抑郁程度明显低于对照组(P<0.01).认为人文关怀护理可缓解患者的紧张、恐惧及抑郁心理,使其积极配合治疗,从而提高了治疗效果.     

Clinical study of shuizhi-dahuang mixture in treating schizophrenics with blood stasis syndrome

A clinical study of 67 female schizophrenics was conducted. Thirty two patients of them treated with the Shuizhi (leech)-Dahuang (rhubarb) mixture mainly with low dosage of antipsychotic drugs (combined therapy group), while other 35 cases were treated with antipsychotic drugs only (control group). The result showed that their overall therapeutic effects were similar and the combined therapy group could reduce the dosages of antipsychotic drugs and its side effects, and tended to normalize the hemorheologic indices.     

A review of patients with high-risk carcinoma of the cervix treated with combined surgery and postoperative radiotherapy

The subacromial bursa is recognized as a site associated with the shoulder pain caused by rotator cuff disease in the middle-aged and elderly. Substance P is contained in primary afferent nerves, and its quantity increases during chronic pain. The amount of substance P in the subacromial bursa of patients with rotator cuff disease was examined. Radioimmunoassay and immunohistochemistry were employed to quantify and localize substance P. The preoperative pain level was measured with a visual analogue scale with 0 as no pain, 5 as moderate, and 10 as severe. Thirty-seven patients that had undergone operation were divided into two groups: one composed of 19 patients with subacromial bursitis and a partial-thickness tear of the rotator cuff (nonperforated cuff) and the other composed of 18 patients with a full-thickness tear (perforated cuff). Subacromial bursae obtained from seven fresh cadavers with no shoulder pain before death were used as controls. The visual analogue scale showed significantly greater pain in the group with the nonperforated rotator cuff than in the group with the perforated cuff. Consistent with these results, the amount of substance P in the subacromial bursa was significantly greater in the former group than in the latter. Nerve fibers immunoreactive to substance P were localized around the vessels, with a larger number of fibers in the group with the nonperforated rotator cuff. Therefore, an increased amount of substance P in the subacromial bursa appears to correlate with the pain caused by rotator cuff disease.