Clinical efficacy of jade wind-barrier powder combined with loratadine in the treatment of pediatric allergic rhinitis.

OBJECTIVE: To investigate the clinical efficacy of Jade Wind-Barrier Powder combined with Loratadine in the treatment of pediatric allergic rhinitis (PAR). METHODS: The clinical data of 101 children with allergic rhinitis (AR) admitted to the Affiliated Hospital of Qingdao University and Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2019 to December 2019 were retrospectively analyzed. The children were randomly divided into Group A (n=50) and Group B (n=51) in accordance with a random number table. Group A was treated with Loratadine only, while Group B was treated with Loratadine combined with Jade Wind-Barrier powder. The clinical efficacy, symptom disappearance time, symptom scores before and after treatment, indices of immunological function, changes in the indices of inflammatory factors and disease recurrence were compared between the two groups. RESULTS: The overall response rate (ORR) in Group B (96.08%) was higher than that in Group A (76.00%) (P < 0.05). The disappearance time of sneezing, stuffy nose, runny nose and itchy nose in Group B was shorter than that in Group A (P < 0.05). After treatment, Group B exhibited lower symptom scores for sneezing, stuffy nose, runny nose and itchy nose, lower levels of IL-13, IL-4 and TNF-α, and higher CD4+CD25+, CD19+ and CD8+ than Group A (P < 0.05). The recurrence rate in Group B (3.92%) was lower than that in Group A (26.00%) (P < 0.05). CONCLUSION: Jade Wind-Barrier powder combined with Loratadine can improve clinical symptoms, immunity, inflammation levels and disease recurrence rate of PAR patients, with a significant clinical efficacy.

[Mixed craniopharyngioma: long-term results after gamma knife combined with stereotactic brachytherapy].

OBJECTIVE: To evaluate the long-term results of combination treatment with Gamma Knife radiosurgery and stereotactic intracavitary brachytherapy for mixed cystic and solid craniopharyngiomas. METHODS: Sixty-seven consecutive patients with mixed cystic and solid craniopharyngioma treated by Gamma Knife radiosurgery combined with stereotactic brachytherapy from October 1996 to December 2005 were selected for retrospective analysis. The inclusion criterion was the patients who survived for at least 5 years after combined treatment. There were 39 male and 28 female patients and the mean age was 31.5 years (ranged from 3 to 70 years). The clinical evaluations including neurological, neuro-ophthalmological, and neuro-endocrinological examinations, assessment of comprehensive quality of life and neuroimaging examinations were performed periodically. The actuarial survival rates and the mean survival time were calculated by using Kaplan-Meier product limit method. The rates were compared using the χ(2) test. RESULTS: Follow-up period varied from 60 to 168 months, with an average of 114 months. The tumor response rate gained from combination treatment with Gamma Knife radiosurgery and stereotactic intracavitary brachytherapy for predominantly solid and cystic craniopharyngiomas were 10/12 and 90.9% respectively, and 89.6% in all. Mean survival after combination treatment was (110 ± 9) months. The mean survival of patients with predominantly solid and cystic craniopharyngioma were (97 ± 12) months and (120 ± 14) months and the actuarial 10-year survival rates were 7/12 and 69.1%. There was no statistics difference in tumor response rate and 10-year survival rate between 2 groups of patients with predominantly solid and cystic craniopharyngioma. The actuarial 5-, 6-, 7-, 8-, 9- and 10-year survival rates were 90.5%, 85.7%, 83.3%, 76.4%, 69.4% and 60.0% respectively. The decreased visual acuity had improved in 68.3% at 6 months postoperatively and in 70.0% in long term results. Comprehensive quality of life in long term follow-up of 67 patients was excellent in 28 cases(41.8%), good in 19 cases(28.4%), fair in 17 cases(25.4%) and poor in 3 cases(4.5%), respectively. The side effects that occurred 6 to 12 months after treatment were worsening of visual acuity (4 patients), dysfunction of hypothalam (4 patients) and third nerve palsy was found in 1 patents 5 years after treatment. The rate of complications was 13.4%. CONCLUSION: Combination treatment with Gamma Knife radiosurgery and stereotactic intracavitary brachytherapy is highly effective and safety in the treatment of mixed cystic and solid craniopharyngiomas.

Stereotactic radiosurgery for trigeminal schwannoma: a clinical retrospective study in 52 cases.

OBJECTIVE: To evaluate the radiological and clinical outcomes in a series of patients in whom stereotactic radiosurgery (SRS) was used to treat trigeminal schwannomas. METHODS: The records of 52 patients who underwent SRS for trigeminal schwannoma were reviewed using a retrospective study. The median patient age was 47.1 years (range, 18-77); 20 patients (38.5%) had undergone prior tumor resection and 32 (61.5%) underwent radiosurgery on the basis of imaging diagnosis only. The most frequent presenting symptoms were facial numbness (29 patients), jaw weakness (11 patients), facial pain (10 patients) and diplopia (4 patients). Fifty-two cases with solid tumors were mainly solid in 44 cases (84.6%), mostly cystic in 2 cases (3.8%), and cystic and solid mixed in 6 cases (11.5%). Two cases of mostly cystic tumor first underwent stereotactic cystic fluid aspiration and intracavitary irradiation, and then had MRI localization scan again for gamma knife treatment. The mean tumor volume was 7.2 ml (range, 0.5-38.2). The mean prescription radiation dose was 13.9 Gy (range, 11-17), and the mean prescription isodose configuration was 47.9%. RESULTS: At a mean follow-up of 61 months (range, 12-156), neurological symptoms or signs improved in 35 patients (67.3%), 14 patients (26.9%) had a stable lesion, and worsening of the disease occurred in 2 patients (3.8%). On imaging, the schwannomas almost disappeared in 8 (15.4%), shrank in 32 (61.5%), remained stable in 5 (9.6%), and increased in size in 7 patients (13.5%). Tumor growth control was achieved in 45 (86.5%) of the 52 patients. CONCLUSIONS: SRS is an effective and minimally invasive management option for patients with residual or newly diagnosed trigeminal schwannomas. The use of SRS to treat trigeminal schwannomas resulted in good tumor control and functional improvement.

[Controlled clinical trials of cost-effectiveness analysis on poking reduction and open reduction for the treatment of sanders type II calcaneal fractures].

OBJECTIVE: To evaluate cost-effectiveness of poking reduction and open reduction for the treatment of Sanders type II calcaneal fractures, in order to provide evidence for standard treatment. METHODS: From 2006.10 to 2008.10, 80 patients with Sanders type II calcaneal fractures were selected from Shandong Provincial Hospital of Traditional Chinese Medicine and randomly divided into poking reduction group and open reduction group with 40 cases in each group. There were 26 males and 14 females in poking reduction group and 30 males and 10 females in open reduction group. The average age of patients in poking reduction group was (36.60+/-3.15) years, and (37.10+/-3.45) years in open reduction group. Bohler angle, Gissane angle, the width of central calcaneus, stance phase of gait, HM-HL,arch index and subtalair joint flexibility were measured. The clinical results and expenses of the two treatment schemes were compared and concluded with the method of cost-effetiveness analysis. RESULTS: In the poking reduction group and open reduction group, the Böhler angle were (30.32+/-1.72) degree and (30.54+/-3.13) degree, Gissane angle were (133.73+/-6.73) degree and (134.86+/-4.90) degree, the width of central calcaneus were (30.18+/-1.59) mm and (30.24+/-1.25) mm, stance phase of gait were (0.679+/-0.070) s and (0.715+/-0.090) s, HM-HL were--(36.49+/-7.56) N and -(34.32+/-6.50) N,arch index were (30.26+/-2.69) and (30.47+/-1.89), and subtalair joint flexibility were (10.53+/-2.30) degree and (10.89+/-1.86) degree respectively. The cost-effectiveness ratio (C/E) were 6.06 and 136.19 respectively. CONCLUSION: Cost-effectiveness ratio of the poking reduction is superior to that of the open reduction in treating Sanders type II calcaneal fractures. Poking reduction is a useful method to treat Sanders type II calcaneal fractures with rapid wound healing and less cost.

[Clinical analysis of 1434 cases of frameless stereotactic operation].

OBJECTIVE: Stereotactic operations were performed using a frameless stereotactic instrument manufactured by CAS-R-2 instead of traditional stereotactic frame. The aim of this study was to assess the clinical usefulness, accuracy and safety of frameless stereotactic instrument. METHODS: The clinical data of 1434 patients was retrospectively reviewed. The mean age was 30.7 years (from 0.2 to 89.0 years). Each patient underwent frameless CT/MRI image-guided stereotactic surgery by this robot system from January 1997 to January 2006. The accuracy of position and improvement of symptom were observed. The averaged period of followed-up was 24 months (from 3 to 48 months). RESULTS: The surgical procedures were performed successfully in all cases. All targets were pointed accurately at first time during the operation. The total effective rate was 93.3% without serious operation related complications. CONCLUSIONS: Compared with the traditional stereotactic operations, this method has some advantages, such as releasing the patient's pain, convenience the doctors, extending the range of indications and increasing the safety and effective of operation.

[Complications following gamma knife radiosurgery].

OBJECTIVE: To investigate complication features following gamma knife radiosurgery (GKR), and to assess factors causing complications. METHODS: A retrospective analysis was conducted for 253 patients with intracranial arteriovenous malformation (AVMs), meningiomas, glial neoplasms, germinomas and metastatic cancer, respectively, which were treated with GKR.The incidences of acute, subacute and late complications following GKR were evaluated. Meanwhile, risk factors inducing subacute complications, such as the cell proliferative population of target tissues and location of target in AVM and meningioma, were evaluated, respectively. RESULTS: The subacute complications are the prominent reactions in all the five diseases. There is a significant difference in the incidence rate of subacute complications between early responding tissues and slow responding tissues, central and peripheral AVM, basal and non-basal meningioma. CONCLUSIONS: Subacute complications are the prominent reactions after GKR, and the reactions are almost always reversible. The risk of subacute complications following GKR treatment is correlated to the proliferative cell population in the target tissues and the target location (AVM, meningioma).

[Neuropathy in nearby cranial nerves after acoustic schwannoma gamma knife radiosurgery, a follow-up study].

OBJECTIVE: To investigate the risks of facial, trigeminal and acoustic neuropathies after acoustic schwannoma gamma knife radiosurgery. METHODS: The clinical data of forty-three patients with 46 masses of acoustic schwannoma who underwent gamma knife radiosurgery with the dose of 12 approximately 15 Gy to the tumor margin between January 1997 and October 2000 and were followed up for 6 approximately 24 months (on average 16.9 months) were studied. The tumor diameter was 10 approximately 20 mm in 12 cases, 21 approximately 30 mm in 23 cases, >/= 31 mm in 11 cases, with the average value of 28 mm. RESULTS: The general tumor control rate was 91.3%. The useful hearing preservation rate was 100% immediately after radiosurgery, 87% 6 months later and 78% 2 years later. The hearing preservation rate was high for small tumors. The facial and trigeminal neuropathies began to appear after 6 months. The incidence rates of facial neuropathy was 15.3%, 7.6%, and 3.8% 6 months, 1 year and 2 years after radiosurgery respectively. The incidence rates of trigeminal neuropathy was 11.4%, 3.8%, and 3.8% respectively 6 months, 1 year, and 2 years after radiosurgery. The incidence of neuropathy was 3.8% for tumors with a diameter < 30 mm for both facial and trigeminal nerves. The hearing in 2 out of 15 cases with dysaudia began to improve 6 months after radiosurgery. The incidence of neuropathy for tumors with the diameter > 30 mm was 3.8% for both nerves 2 years after raadiosurgery. The preservation rate of useful hearing for tumors with the diameter < 20 mm was 100% after radiosurgery. CONCLUSION: Stereotactic radiosurgery using gamma knife with a dose of 12 approximately 15 Gy to the tumor margin succeeds in controlling acoustic schwannoma and preserving useful hearing. The incidence of facial and trigeminal neuropathies are low. The neuropathy caused by gamma knife radiosurgery is sub-lethal and can be recovered gradually.

[Computer-assisted planning for neurosurgery: a clinical study].

OBJECTIVE: To investigate the clinical effect of computer-assisted planning for neurosurgery (CAPN). METHODS: 100 groups of directional targets were randomly sampled. The targets' directional three-dimension coordinates measured with CAPN and those measured by traditional reading device were analyzed statistically. CAPN was actualized in 137 cases of stereotactic operation. RESULTS: The data measured with CAPN and those with traditional reading device were analyzed with two samples. The paired t test showed no statistically significantly difference between the data of targets measured by both methods (t < t(0.05/2,99)=1.984, P >< 0.05). Different kinds of operation based on CAPN were performed upon 137 cases success fully. CAPN was proved reliable. All operations were successful and the clinic effects satisfactory. CONCLUSION: CAPN is accurate and reliable, and has positive effect on the improvement of stereotactic neurosurgery.