Objective： To study the efficacy of modified Wuzhuyu Decoction Granule （加减吴茱萸汤颗粒剂, MWDG） in the treatment of migraine patients with cold and stasis obstructing meridian syndrome. Methods： This study was a...Objective： To study the efficacy of modified Wuzhuyu Decoction Granule （加减吴茱萸汤颗粒剂, MWDG） in the treatment of migraine patients with cold and stasis obstructing meridian syndrome. Methods： This study was a randomized, double-blind, placebo-controlled trial. A total of 78 migraine patients with cold and stasis obstructing meridian syndrome were recruited and randomly assigned by a ratio of 2：1 into a treatment group （51 cases） and a placebo group （27 cases）. Patients in the treatment group were treated with MWDG while placebo granules were applied in the control group. The treatment course lasted for 12 weeks with a follow-up of 4 weeks. The primary outcome measures included frequency and days of migraine attacks and the secondary outcome measures were analgesics consumption and visual analogue scale （VAS） scores. All outcome assessments were conducted respectively at baseline, the 4th, 8th and 12th week, and the end of follow-up. Results： In the treatment group, significant decrease in frequency of migraine attacks were observed since the 4th week and that of analgesics consumption since the 8th week （both P〈0.05）. While, in the placebo group, significant decrease in frequency of migraine attacks were observed since the 8th week and that of analgesics consumption since the 12th week （both P〈0.05）. No significant decrease in days of migraine attacks and VAS scores of migraine pain were observed in both groups. Between the two groups, there were significant differences in VAS scores and intensity of pain appeared in the 8th week （P〈0.05）. However, no significant differences were found in days and frequency of migraine attacks and analgesics consumption （P〉0.05）. Conclusions： MWDG was probably effective in the treatment of migraine especially for alleviating pain intensity. Furthermore, MWDG could reduce the frequency of migraine attacks and analgesics consumption sooner than the placebo.展开更多
BACKGROUND Stenting as a bridge to curative surgery(SBTS)for obstructing colon cancer(OCC)has been associated with possibly worse oncological outcomes.AIM To evaluate the recurrence patterns,survival outcomes,and colo...BACKGROUND Stenting as a bridge to curative surgery(SBTS)for obstructing colon cancer(OCC)has been associated with possibly worse oncological outcomes.AIM To evaluate the recurrence patterns,survival outcomes,and colorectal cancer(CRC)-specific death in patients undergoing SBTS for OCC.METHODS Data from 62 patients undergoing SBTS at a single tertiary centre over ten years between 2007 and 2016 were retrospectively examined.Primary outcomes were recurrence patterns,overall survival(OS),cancer-specific survival(CSS),and CRC-specific death.OS and CSS were estimated using the Kaplan-Meier curves.Competing risk analysis with cumulative incidence function(CIF)was used to estimate CRC-specific mortality with other cause-specific death as a competing event.Fine-Gray regressions were performed to determine prognostic factors of CRC-specific death.Univariate and multivariate subdistribution hazard ratios and their corresponding Wald test P values were calculated.RESULTS 28 patients(45.2%)developed metastases after a median period of 16 mo.Among the 18 patients with single-site metastases:Four had lung-only metastases(14.3%),four had liver-only metastases(14.3%),and 10 had peritoneum-only metastases(35.7%),while 10 patients had two or more sites of metastatic disease(35.7%).The peritoneum was the most prevalent(60.7%)site of metastatic involvement(17/28).The median follow-up duration was 46 mo.26(41.9%)of the 62 patients died,of which 16(61.5%)were CRC-specific deaths and 10(38.5%)were deaths owing to other causes. The 1-, 3-, and 5-year OS probabilities were 88%, 74%, and 59%;1-, 3-, and5-year CSS probabilities were 97%, 83%, and 67%. The highest CIF for CRC-specific death at 60 mowas liver-only recurrence (0.69). Liver-only recurrence, peritoneum-only recurrence, and two ormore recurrence sites were predictive of CRC-specific death.CONCLUSIONThe peritoneum was the most common metastatic site among patients undergoing SBTS. Liveronlyrecurrence, peritoneum-only recurrence, and two or more recurrence sites were predictors o展开更多
Biliary obstructions can lead to infections of the biliary system, particularly in patients with occluded biliary stents. Fungal organisms are frequently found in bili-ary aspirates of patients who have been on antibi...Biliary obstructions can lead to infections of the biliary system, particularly in patients with occluded biliary stents. Fungal organisms are frequently found in bili-ary aspirates of patients who have been on antibiotics and have stents; however, fungal masses, or "balls", that fully obstruct the biliary system are uncommon and exceedingly diff icult to eradicate. We present 4 cases of obstructing fungal cholangitis in patients who had metal biliary stents placed for pancreatic malignancies, and subsequently required aggressive antifungal administration along with endoscopic and radiologic interventions. This report also reviews approaches previously undertaken to manage severe obstructing fungal cholangitis.展开更多
Objective:To observe the clinical efficacy and safety of oral administration of the traditional Chinese herb rhubarb to treat acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:This was a multi...Objective:To observe the clinical efficacy and safety of oral administration of the traditional Chinese herb rhubarb to treat acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:This was a multicenter randomized double-blinded placebo controlled study that took place in 7 provinces of China that enrolled 244 patients(aged 18e80 years)who had acute exacerbation of COPD with the traditional Chinese syndrome pattern of phlegm-heat obstructing lung.Participants were divided into experimental and control groups.The experimental group received 4.5 g of rhubarb granules twice daily and the control group received placebo granules.Both groups also received conventional Western therapy consisting of oxygen therapy,an antibiotic,expectorant,and a bronchodilator.Treatment lasted 10 days.Symptom scores for cough,sputum volume and color,wheezing and chest tightness before treatment and on days 3,5,7,and 10 during the treatment were recorded.Lung function,arterial blood gas and levels of serum inflammatory factors,interleukin-4(IL-4),interleukin-8(IL-8),and interleukin-10(IL-10)and tumor necrosis factor-alpha(TNF-a),before and after treatment were measured.Results:The sample size of the full analysis set(FAS)was 244 participants,and the sample size of per protocol set(PPS)was 235.Following 10 days’treatment,symptom scores of the experimental group were markedly lower than those of the placebo group(FAS:mean difference1.67,95%CI:e2.66 to0.69,P Z 0.001;PPS:mean difference1.55,95%CI:2.56 to0.54,P Z 0.003).Lung function in the experimental group was significantly higher than in the placebo group(FEV1,FAS:mean difference 0.12,95%CI:0.06 to 0.18;P<0.001;PPS:mean difference 0.12,95%CI 0.05 to 0.18;P<0.001.FVC:FAS:mean difference 0.16,95%CI:0.06 to 0.26;P Z 0.002;PPS:mean difference 0.16,95%CI 0.05 to 0.26;P Z 0.003.FEV1%,FAS:mean difference 5.95,95%CI:3.36 to 8.53;P<0.001;PPS:mean difference 5.92,95%CI 3.28 to 8.56;P<0.001.).PaO2,PaCO2,as well as serum inflammatory factors were also improved when compared展开更多
Objective:To explore the molecular mechanism of the prescription for the syndrome of cold-damp-ness obstructing the lung in the treatment of corona virus disease 2019(COVID-19).Methods:The medicinals for the treatment...Objective:To explore the molecular mechanism of the prescription for the syndrome of cold-damp-ness obstructing the lung in the treatment of corona virus disease 2019(COVID-19).Methods:The medicinals for the treatment of the syndrome of cold-dampness obstructing the lung,such as Cangzhu(Rhizoma Atractylo-dis),Chenpi(Pericarpium Gitri Reticulatae),Houpo(Cortex Magnoliae Officinalis),Huoxiang(Herba Agastachis),Caoguo(Fructus Tsaoko),Mahuang(Herba Ephedrae),Qianghuo(Rhizoma et Radix Notoptery-gi),Shengjiang(Rhizoma Zingiberis Recens),Binlang(Semen Arecae)in the Diagnosis and Treatment Pro-gram of COVID-19(Trial Version 6)were taken as research subjects,and the combination of these nine me-dicinals can be called Hanshi Zufei Fang(寒湿阻肺方,HSZFF).The active components and targets of each single Chinese materia medica was screened and obtained through the Traditional Chinese Medicine Systems Pharmacology(TCMSP)database.The target information related to COVID-19 was retrieved through the Gene-Cards disease-related target database.The medicinal prediction targets were mapped to the disease target to ob-tain the intersection targets.The DAVID database was applied to perform gene ontology(GO)enrichment anal-ysis and kyoto encyclopedia of genes and genomes(KEGG)pathway analysis on the targets;GraphPad Prism 5.0 software was applied to plot the biological process(BP)of GO enrichment analysis,cellular component(CC),molecular function(MF)histograms;OmicShare online software was applied to make KEGG advanced bubble chart;Cytoscape software was applied to visualize the interaction with the targets and Chinese materia medica-components-targets results.Results:Totally 56 key active components of 9 Chinese materia medica for cold-dampness obstructing lung syndrome were screened,and 55 targets were obtained.The results of GO and KEGG enrichment analysis showed that the compound prescription mainly regulated the body's immune re-sponse and reduced inflammation by regulating such signaling pathways of inflammatory response and 展开更多
AIM: To see the possibility of avoiding routine colostomy in patients presenting with unprepared bowel. METHODS: The cohort is composed of 103 patients, of these, 86 patients presented as emergencies (self- inflected ...AIM: To see the possibility of avoiding routine colostomy in patients presenting with unprepared bowel. METHODS: The cohort is composed of 103 patients, of these, 86 patients presented as emergencies (self- inflected and iatrogenic colon injuries, stab wounds and blast injury of the colon, volvulus sigmoid, obstructing left colon cancer, and strangulated ventral hernia). Another 17 patients were managed electively for other colon pathologies. During laparotomy, the involved segment was resected and the two ends of the colon were brought out via a separate colostomy wound. One layer of interrupted 3/0 silk was used for colon anastomosis. The exteriorized segment was immediately covered with a colostomy bag. Between the 5th and 7th postoperative day, the colon was easily dropped into the peritoneal cavity. The defect in the abdominal wall was closed with interrupted nonabsorbable suture. The skin was left open for secondary closure. RESULTS: The mean hospital stay (± SD) was 11.5 ± 2.6 d (8-20 d). The exteriorized colon was successfully dropped back into the peritoneal cavity in all patients except two. One developed a leak from oesophago- jejunostomy and from the exteriorized colon. She subsequently died of sepsis and multiple organ failure (MOF). In a second patient the colon proximal to the exteriorized anastomosis prolapsed and developed severe serositis, an elective ileo-colic anastomosis (to the left colon) was successfully performed. CONCLUSION: Exteriorized colon anastomosis is simple, avoids the inconvenience of colostomy and can be an alternative to routine colostomy. It is suitable where colostomy is socially unacceptable or the facilities and care is not available.展开更多
基金Supported by the "Eleventh Five-Year Plan" of China State Science&Technology Ministry(No.2007BAI20B053)National Natural Science Foundation of China(No.81273688)
文摘Objective： To study the efficacy of modified Wuzhuyu Decoction Granule （加减吴茱萸汤颗粒剂, MWDG） in the treatment of migraine patients with cold and stasis obstructing meridian syndrome. Methods： This study was a randomized, double-blind, placebo-controlled trial. A total of 78 migraine patients with cold and stasis obstructing meridian syndrome were recruited and randomly assigned by a ratio of 2：1 into a treatment group （51 cases） and a placebo group （27 cases）. Patients in the treatment group were treated with MWDG while placebo granules were applied in the control group. The treatment course lasted for 12 weeks with a follow-up of 4 weeks. The primary outcome measures included frequency and days of migraine attacks and the secondary outcome measures were analgesics consumption and visual analogue scale （VAS） scores. All outcome assessments were conducted respectively at baseline, the 4th, 8th and 12th week, and the end of follow-up. Results： In the treatment group, significant decrease in frequency of migraine attacks were observed since the 4th week and that of analgesics consumption since the 8th week （both P〈0.05）. While, in the placebo group, significant decrease in frequency of migraine attacks were observed since the 8th week and that of analgesics consumption since the 12th week （both P〈0.05）. No significant decrease in days of migraine attacks and VAS scores of migraine pain were observed in both groups. Between the two groups, there were significant differences in VAS scores and intensity of pain appeared in the 8th week （P〈0.05）. However, no significant differences were found in days and frequency of migraine attacks and analgesics consumption （P〉0.05）. Conclusions： MWDG was probably effective in the treatment of migraine especially for alleviating pain intensity. Furthermore, MWDG could reduce the frequency of migraine attacks and analgesics consumption sooner than the placebo.
文摘BACKGROUND Stenting as a bridge to curative surgery(SBTS)for obstructing colon cancer(OCC)has been associated with possibly worse oncological outcomes.AIM To evaluate the recurrence patterns,survival outcomes,and colorectal cancer(CRC)-specific death in patients undergoing SBTS for OCC.METHODS Data from 62 patients undergoing SBTS at a single tertiary centre over ten years between 2007 and 2016 were retrospectively examined.Primary outcomes were recurrence patterns,overall survival(OS),cancer-specific survival(CSS),and CRC-specific death.OS and CSS were estimated using the Kaplan-Meier curves.Competing risk analysis with cumulative incidence function(CIF)was used to estimate CRC-specific mortality with other cause-specific death as a competing event.Fine-Gray regressions were performed to determine prognostic factors of CRC-specific death.Univariate and multivariate subdistribution hazard ratios and their corresponding Wald test P values were calculated.RESULTS 28 patients(45.2%)developed metastases after a median period of 16 mo.Among the 18 patients with single-site metastases:Four had lung-only metastases(14.3%),four had liver-only metastases(14.3%),and 10 had peritoneum-only metastases(35.7%),while 10 patients had two or more sites of metastatic disease(35.7%).The peritoneum was the most prevalent(60.7%)site of metastatic involvement(17/28).The median follow-up duration was 46 mo.26(41.9%)of the 62 patients died,of which 16(61.5%)were CRC-specific deaths and 10(38.5%)were deaths owing to other causes. The 1-, 3-, and 5-year OS probabilities were 88%, 74%, and 59%;1-, 3-, and5-year CSS probabilities were 97%, 83%, and 67%. The highest CIF for CRC-specific death at 60 mowas liver-only recurrence (0.69). Liver-only recurrence, peritoneum-only recurrence, and two ormore recurrence sites were predictive of CRC-specific death.CONCLUSIONThe peritoneum was the most common metastatic site among patients undergoing SBTS. Liveronlyrecurrence, peritoneum-only recurrence, and two or more recurrence sites were predictors o
文摘Biliary obstructions can lead to infections of the biliary system, particularly in patients with occluded biliary stents. Fungal organisms are frequently found in bili-ary aspirates of patients who have been on antibiotics and have stents; however, fungal masses, or "balls", that fully obstruct the biliary system are uncommon and exceedingly diff icult to eradicate. We present 4 cases of obstructing fungal cholangitis in patients who had metal biliary stents placed for pancreatic malignancies, and subsequently required aggressive antifungal administration along with endoscopic and radiologic interventions. This report also reviews approaches previously undertaken to manage severe obstructing fungal cholangitis.
基金This study was funded by the China National Key Basic Research Project through The Ministry of Science and Technology(No.2009CB522704).
文摘Objective:To observe the clinical efficacy and safety of oral administration of the traditional Chinese herb rhubarb to treat acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:This was a multicenter randomized double-blinded placebo controlled study that took place in 7 provinces of China that enrolled 244 patients(aged 18e80 years)who had acute exacerbation of COPD with the traditional Chinese syndrome pattern of phlegm-heat obstructing lung.Participants were divided into experimental and control groups.The experimental group received 4.5 g of rhubarb granules twice daily and the control group received placebo granules.Both groups also received conventional Western therapy consisting of oxygen therapy,an antibiotic,expectorant,and a bronchodilator.Treatment lasted 10 days.Symptom scores for cough,sputum volume and color,wheezing and chest tightness before treatment and on days 3,5,7,and 10 during the treatment were recorded.Lung function,arterial blood gas and levels of serum inflammatory factors,interleukin-4(IL-4),interleukin-8(IL-8),and interleukin-10(IL-10)and tumor necrosis factor-alpha(TNF-a),before and after treatment were measured.Results:The sample size of the full analysis set(FAS)was 244 participants,and the sample size of per protocol set(PPS)was 235.Following 10 days’treatment,symptom scores of the experimental group were markedly lower than those of the placebo group(FAS:mean difference1.67,95%CI:e2.66 to0.69,P Z 0.001;PPS:mean difference1.55,95%CI:2.56 to0.54,P Z 0.003).Lung function in the experimental group was significantly higher than in the placebo group(FEV1,FAS:mean difference 0.12,95%CI:0.06 to 0.18;P<0.001;PPS:mean difference 0.12,95%CI 0.05 to 0.18;P<0.001.FVC:FAS:mean difference 0.16,95%CI:0.06 to 0.26;P Z 0.002;PPS:mean difference 0.16,95%CI 0.05 to 0.26;P Z 0.003.FEV1%,FAS:mean difference 5.95,95%CI:3.36 to 8.53;P<0.001;PPS:mean difference 5.92,95%CI 3.28 to 8.56;P<0.001.).PaO2,PaCO2,as well as serum inflammatory factors were also improved when compared
基金We thank for the funding support from the National Natural Science Foundation of China(81873285)。
文摘Objective:To explore the molecular mechanism of the prescription for the syndrome of cold-damp-ness obstructing the lung in the treatment of corona virus disease 2019(COVID-19).Methods:The medicinals for the treatment of the syndrome of cold-dampness obstructing the lung,such as Cangzhu(Rhizoma Atractylo-dis),Chenpi(Pericarpium Gitri Reticulatae),Houpo(Cortex Magnoliae Officinalis),Huoxiang(Herba Agastachis),Caoguo(Fructus Tsaoko),Mahuang(Herba Ephedrae),Qianghuo(Rhizoma et Radix Notoptery-gi),Shengjiang(Rhizoma Zingiberis Recens),Binlang(Semen Arecae)in the Diagnosis and Treatment Pro-gram of COVID-19(Trial Version 6)were taken as research subjects,and the combination of these nine me-dicinals can be called Hanshi Zufei Fang(寒湿阻肺方,HSZFF).The active components and targets of each single Chinese materia medica was screened and obtained through the Traditional Chinese Medicine Systems Pharmacology(TCMSP)database.The target information related to COVID-19 was retrieved through the Gene-Cards disease-related target database.The medicinal prediction targets were mapped to the disease target to ob-tain the intersection targets.The DAVID database was applied to perform gene ontology(GO)enrichment anal-ysis and kyoto encyclopedia of genes and genomes(KEGG)pathway analysis on the targets;GraphPad Prism 5.0 software was applied to plot the biological process(BP)of GO enrichment analysis,cellular component(CC),molecular function(MF)histograms;OmicShare online software was applied to make KEGG advanced bubble chart;Cytoscape software was applied to visualize the interaction with the targets and Chinese materia medica-components-targets results.Results:Totally 56 key active components of 9 Chinese materia medica for cold-dampness obstructing lung syndrome were screened,and 55 targets were obtained.The results of GO and KEGG enrichment analysis showed that the compound prescription mainly regulated the body's immune re-sponse and reduced inflammation by regulating such signaling pathways of inflammatory response and
文摘AIM: To see the possibility of avoiding routine colostomy in patients presenting with unprepared bowel. METHODS: The cohort is composed of 103 patients, of these, 86 patients presented as emergencies (self- inflected and iatrogenic colon injuries, stab wounds and blast injury of the colon, volvulus sigmoid, obstructing left colon cancer, and strangulated ventral hernia). Another 17 patients were managed electively for other colon pathologies. During laparotomy, the involved segment was resected and the two ends of the colon were brought out via a separate colostomy wound. One layer of interrupted 3/0 silk was used for colon anastomosis. The exteriorized segment was immediately covered with a colostomy bag. Between the 5th and 7th postoperative day, the colon was easily dropped into the peritoneal cavity. The defect in the abdominal wall was closed with interrupted nonabsorbable suture. The skin was left open for secondary closure. RESULTS: The mean hospital stay (± SD) was 11.5 ± 2.6 d (8-20 d). The exteriorized colon was successfully dropped back into the peritoneal cavity in all patients except two. One developed a leak from oesophago- jejunostomy and from the exteriorized colon. She subsequently died of sepsis and multiple organ failure (MOF). In a second patient the colon proximal to the exteriorized anastomosis prolapsed and developed severe serositis, an elective ileo-colic anastomosis (to the left colon) was successfully performed. CONCLUSION: Exteriorized colon anastomosis is simple, avoids the inconvenience of colostomy and can be an alternative to routine colostomy. It is suitable where colostomy is socially unacceptable or the facilities and care is not available.
