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ObjectiveTo evaluate the clinical efficacy and safety of Tongluo Mingmu capsules in the treatment of diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome. MethodA randomized， double-blind， positive-control， and multi-center clinical trial design method was used. 416 patients with diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome in four test centers were included （the ratio of the treatment group to the control group was 3∶1）. On the basis of standardized hypoglycemic treatment， the treatment group was given both four Tongluo Mingmu capsules and two Calcium Dobesilate capsule agents three times a day， while the control group were given both two Calcium Dobesilate capsules and four Tongluo Mingmu capsule agents three times a day. The course of treatment was 12 weeks. The curative effect of Tongluo Mingmu capsules was evaluated by comparing the comprehensive curative effect of diabetic retinopathy， traditional Chinese medicine（TCM） syndrome score， corrected visual acuity， fundus changes， fundus fluorescence angiography， and other curative effect indexes before and after treatment in the two groups. At the same time， general examination， laboratory examination， and adverse events were performed to evaluate the safety of the drug. ResultThe baseline demographic data and disease characteristics of the treatment group and the control group were balanced and comparable， with the difference not statistically significant. After 12 weeks of treatment， the total effective rate of the comprehensive curative effect of diabetic retinopathy in the treatment group （61.0%， 189/310） was better than that in the control group （44.1%， 45/102）， and the difference was statistically significant （χ2=8.880， P<0.01）. The total effective rate of TCM syndromes in the treatment group （88.4%， 259/293） was better than that in the control group （69.9%， 65/93）， and the difference was statistically significant （χ2=17.927， P<0.01）. The disappearance rate of dry eyes （χ2=8.305）， dull complexion （χ2=4.053）， lassitude （χ2=10.267）， shortness of breath （χ2=8.494）， and dry stool （χ2=8.657） in the treatment group was higher than that in the control group， and the difference between the groups was statistically significant （P<0.05， P<0.01）. In terms of improving corrected visual acuity （χ2=8.382）， fundus changes （χ2=6.026） ， the treatment group was significantly better than the control group （P<0.05）. During the trial， the incidence of adverse events in the treatment group and the control group was 1.3% and 2.9%， respectively. There was no significant difference between the two groups. In addition， there were no serious adverse events and adverse events leading to withdrawal in both groups. ConclusionTongluo Mingmu capsules can improve the comprehensive curative effect of diabetic retinopathy and enhance the efficacy of TCM syndromes， visual acuity， fundus changes， and fundus fluorescein angiography， with great safety. Therefore， it can provide a new alternative therapeutic drug for patients with diabetic retinopathy.
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ObjectiveTo confirm the clinical efficacy and safety of Yishen Yangxin Anshen tablets in the treatment of insomnia （heart-blood deficiency and kidney-essence insufficiency syndrome）. MethodA randomized block， double-blind， placebo-controlled， multi-center clinical trial design method was adopted， and a total of 480 patients with insomnia due to deficiency of heart blood and insufficiency of kidney essence （treatment group-control group 3∶1） from seven hospitals （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， The First Clinical Hospital， Jilin Province Academy of Traditional Chinese Medicine（TCM）， The Second Affiliated Hospital of Liaoning University of TCM， The First Affiliated Hospital of Henan University of Chinese Medicine， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine） were enrolled. The treatment group was given Yishen Yangxin Anshen tablets and the control group received placebo tablets （4 tablets/time， 3 times/day， 4 weeks of administration， 4 weeks of follow-up after drug withdrawal）. The sleep dysfunction rating scale （SDRS） score， pittsburgh sleep quality index （PSQI） score， TCM， polysomnography （PSG） indicators from four hospital （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine）， and other efficacy indicators were compared between the two groups before and after treatment. Through general physical examination， laboratory examination， and observation of adverse events， the safety of the drugs was evaluated. ResultThe baseline indexes of the two groups showed no significant difference and thus the two groups were comparable. After treatment， the total score of SDRS in the treatment group was lower than that in the control group （P<0.01）. After drug withdrawal for 4 weeks， the total score of SDRS demonstrated no significant change in the treatment group as compared with that at the end of treatment， indicating that the rebound change of curative effect was not obvious. After treatment， the total score of PSQI in the treatment group decreased as compared with that in the control group （P<0.01）， and the change of total score of PSQI in the treatment group was statistically significant （P<0.05） after drug withdrawal for 4 weeks but small， indicating that the rebound change of curative effect was not obvious. After treatment， the total effective rate about the TCM symptoms in the treatment group was higher than that in the control group （χ2=137.521，P<0.01）. After treatment， the disappearance rates of single indexes in the treatment group， such as difficulty in falling asleep， easily waking up after sleeping， early awakening， short sleep time， dreamfulness， palpitation， forgetfulness， dizziness， mental fatigue， and weakness of waist and knee， increased compared with those in the control group （P<0.01）. After treatment， the treatment group demonstrated fewer awaking times （AT）， longer total sleep time （TST）， lower ATA/TST ratio， and higher sleep efficiency （%） than the control group （P<0.05）. No abnormal value or aggravation related to drugs was observed in either group. The incidence of adverse events in the treatment group and the control group was 5.57% and 8.40% respectively. No serious adverse events or adverse events leading to withdrawal happened in either group. ConclusionYishen Yangxin Anshen tablets is effective and safe for patients with insomnia of deficiency of heart-blood and insufficiency of kidney-essence.
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Objective To explore CT manifestations of the lung in Castleman disease (CD) patients.Methods Totally 14 CD patients with abnormal pulmonary manifestations were enrolled,including 8 multicentric CD (MCD) and 6 unicentric CD (UCD).CT manifestations of the lung were analyzed retrospectively.Results In 3 patients of pulmonary hilar UCD,CT showed circular masses with solitary homogeneous density,obviously or markedly enhanced after contrast media administration.Bronchiolitis obliterans was found in 1 patient of retroperitoneal UCD with paraneoplastic pemphigus.Two patients of mediastinal UCD showed well defined centrilobular nodules in the lung.Eight patients of MCD mainly showed multiple small nodules,and large nodules with diameters of 1-2 cm were found in 2 of them.Four patients showed poorly defined nodules,and the rest 4 showed well-defined nodules.The nodules were mainly demonstrated as small centrilobular nodules,and a few of them located in subpleural regions in 3 patients.Other CT signs included interlobular septal thickening in 4 patients,ground glass opacity in 4 patients,streaks in 4 patients,patchy consolidation in 3 patients,cysts in 2 patients and thickening of the bronchovascular bundles in 1 patient.Conclusion CT manifestations of the lung in CD patients are complex and variable,and might be related to pathological types.
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A 60-year-old female presented with abdominal pain and tenderness of five-day duration. Contrast enhanced CT showed a mass of 9 x 6 x 5.5 cm in size with almost complete obliteration of the inferior vena cava and massive extension to the extravascular space. CT-guided biopsy demonstrated a low-grade leiomyosarcoma. The patient underwent 125Iodine seeds implantation in two sessions, and another balloon cavoplasty. Abdominal pain and tenderness gradually improved and the patient continues to remain as disease free state for three years after the procedures.
Subject(s)
Female , Humans , Middle Aged , Brachytherapy/methods , Contrast Media , Iodine Radioisotopes/therapeutic use , Leiomyosarcoma/diagnostic imaging , Tomography, X-Ray Computed , Vascular Neoplasms/diagnostic imaging , Vena Cava, InferiorABSTRACT
Objective To discuss the injury spectrum and traumatic condition spectrum of trauma of abdominal organs in recent years. Methods Data of 247 cases with trauma on abdominal organ admitted in our hospital from 1999 to 2001 were analyzed in respects of injury spectrum, sex, age, vocation and injury causes of the cases with trauma of abdominal organs. Traumatic condition was evaluated by abridged injury score-injury severity score (AIS-ISS). Results There were 54 cases with trauma of abdominal organs in 1999, 72 in 2000 and 121 in 2001. Of all, 241 cases were cured but 6 died, with a fatality rate of 2.5%. The occurrence frequency of trauma of abdominal organs could be ranked in turn as follows: the spleen (43.2%), the kidney (18.8%), the liver (13.7%), the small intestine (6.5%),the bladder (4.8%), the pancreas (3.8%), the colon (3.8%), the stomach, the duodenum and the rectum. A total of 192 cases at age under 40 years accounted for 77.7% . Three injury causes ranked the first three places were traffic accident in 95 cases (38.5%), fall in 54 (21.9%), kick and boxing in 36 (14.6%), respectively. Of all, 168 cases had only intraabdominal injuries, of which 80 (47.6%) were with AIS=3, 32 (19.0%) with AIS=4 and 10 (6.0%) with AIS=5; and the other 79 cases (32.0%) were complicated by multiple trauma, with ISS ≥16 in 27 cases (34.2%) and ISS ≥25 in 8 (10.1%). Conclusions With the increase of vehicles and current personnel, the trauma of abdominal organs caused by traffic accident, accidental wound and conflict increases accordingly. People most apt to organ injuries are farmers, students and workers. Three organs ranked first three places are the spleen, the kidney and the liver. More than half cases are injured severely in accordance with AIS. To decrease trauma of abdominal organs, we must strengthen the education on traffic safety to raise their bewareness of injuries.
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Objective To study the curative effect of internal thoracic arterial chemoembolization in the treatment of advanced lung cancer.Methods Internal thoracic artery was confirmed to be the main supplied artery by digital substraction angiography(DSA) in 8 cases with lung cancer. The internal thoracic artery was embolized by stainless steel coil below the supplied segment in order to avoid the normal vascular territory occlusion.Then iodized oil combined with Cis-Diaminedichloroplatinum(DDP) and mitomycin(MMC) were injected into the supplied segment slowly until blood flow stopped,at last,the gelfoam sponge sheet was inserted into this supplied segment to decrease the wash of iodized oil by blood flow.Results Clinical symptoms were improved obviously in all cases after therapy.CT scans showed that iodized oil accumulated in the tumor better four weeks after the chemoembolization. Conclusion For these cases with advanced lung cancer which the blood supply mainly by internal thoracic artery,it is necessary to perform chemoembolization.
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Objective To assess the cli ni cal usefulness of dual-modality positron emission tomographic (PET)-computed t omographic (CT) imaging in pulmonary lesions. Methods Fo rty-nine patients with pulmonary lesions examined with ?~2 test. Results There were 50 primary lesions in 49 patients. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predict ive value (NPV) were 90.0%, 95.2%, 62.5%, 93.0%, and 71.4%, respectively wi th PET-CT, 74.0%, 76.2%, 62.5%, 91.4%, and 33.3%, respectively with CT. There was significant differences between them (P0.05). Conclusion PET-C T has an important clinical value in differentiating benign lesion from malignan cy and staging in lung cancer.