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Objective To investigate the clinical effects of Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme in the treatment of advanced ovarian carcinoma in elderly patients. Methods A total of 218 elderly patients with advanced ovarian carcinoma in our hospital were randomly divided into the observation and control group, 109 in each group. The control group was treated by TP scheme, while the observation group was treated by Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme. Both groups received 1 chemotherapy cycle at 3 weeks, and a total of 4 cycles of chemotherapy were followed up for 2 years. Quality of life was assessed by Functional Assessment of Cancer Therapy- ovarian Cancer v4.0 (FACT-OV4). Enzyme-linked immunosorbent assay (ELISA) was used to detect tumor markers, including Integrin-Linked Kinase (ILK), Hypoxic Inducible Factor-α (HIF-α), Human Epididymal Protein (HE4) and Epithelial-type calcium mucin (E-cadherin). The toxic and side effects of two groups were observed and the clinical efficacy was evaluated. The survival rate, total survival time and disease-free survival time were observed and recorded during follow-up. Results The control rate and effective rate of the observation group were 90.8% (99/109) and 41.3% (45/109), respectively, and those of the control group were 64.2% (70/109) and 28.4% (31/109), respectively. The comparison of control rate and effective rate between the two groups were statistically significant (Z value were 4.002, 3.401, respectively, all Ps<0.05). After treatment, the ILK (12.31 ± 1.15 ng/L vs. 23.57 ± 2.32 ng/L, t=3.245), HIF-α (2.41 ± 0.22 mg/L vs. 6.67 ± 0.67 mg/L, t=3.596), HE4 (0.34 ± 0.03 pg/L vs. 1.24 ± 0.12 pg/L, t=3.621) levels in the observation group are significantly lower than those in the control group (P<0.05), while the E-cadherin (5.25 ± 0.56 ng/L vs. 2.52 ± 0.26 ng/L, t=3.434) was significantly higher than that in the control group (P<0.05). After treatment, the scores of functional status and social/family status in the observation group were significantly higher than those in the control group (t values were 3.282, 3.214, all Ps<0.05), and the scores of additional attention, emotional status and physiological status were significantly lower than those in the control group (t values were 3.121, 3.512, 3.526, all Ps<0.05). During the treatment period, the incidence of cardiac toxicity, liver toxicity, renal toxicity, bone marrow suppression, nausea and vomiting, abdominal pain and diarrhea in the observation group were significantly lower than those in the control group (χ2 value were 4.947, 4.893, 4.525, 4.692, 4.637, 4.905, respectively, all Ps<0.05). During the follow-up, the 1, 2 year survival rate in the observation group was higher than those in the control group (χ2 value were 3.782, 3.893, respectively, all Ps<0.05). Conclusions The Kangai-Guben-Xiaozheng decoction based on the theory of cancer pathogenesis, combined with TP regimen show effectiveness for the Ⅳ stage of ovarian cancer of the elderly patients.
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Objective@#To investigate the clinical effects of Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme in the treatment of advanced ovarian carcinoma in elderly patients.@*Methods@#A total of 218 elderly patients with advanced ovarian carcinoma in our hospital were randomly divided into the observation and control group, 109 in each group. The control group was treated by TP scheme, while the observation group was treated by Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme. Both groups received 1 chemotherapy cycle at 3 weeks, and a total of 4 cycles of chemotherapy were followed up for 2 years. Quality of life was assessed by Functional Assessment of Cancer Therapy- ovarian Cancer v4.0 (FACT-OV4). Enzyme-linked immunosorbent assay (ELISA) was used to detect tumor markers, including Integrin-Linked Kinase (ILK), Hypoxic Inducible Factor-α (HIF-α), Human Epididymal Protein (HE4) and Epithelial-type calcium mucin (E-cadherin). The toxic and side effects of two groups were observed and the clinical efficacy was evaluated. The survival rate, total survival time and disease-free survival time were observed and recorded during follow-up.@*Results@#The control rate and effective rate of the observation group were 90.8% (99/109) and 41.3% (45/109), respectively, and those of the control group were 64.2% (70/109) and 28.4% (31/109), respectively. The comparison of control rate and effective rate between the two groups were statistically significant (Z value were 4.002, 3.401, respectively, all Ps<0.05). After treatment, the ILK (12.31 ± 1.15 ng/L vs. 23.57 ± 2.32 ng/L, t=3.245), HIF-α (2.41 ± 0.22 mg/L vs. 6.67 ± 0.67 mg/L, t=3.596), HE4 (0.34 ± 0.03 pg/L vs. 1.24 ± 0.12 pg/L, t=3.621) levels in the observation group are significantly lower than those in the control group (P<0.05), while the E-cadherin (5.25 ± 0.56 ng/L vs. 2.52 ± 0.26 ng/L, t=3.434) was significantly higher than that in the control group (P<0.05). After treatment, the scores of functional status and social/family status in the observation group were significantly higher than those in the control group (t values were 3.282, 3.214, all Ps<0.05), and the scores of additional attention, emotional status and physiological status were significantly lower than those in the control group (t values were 3.121, 3.512, 3.526, all Ps<0.05). During the treatment period, the incidence of cardiac toxicity, liver toxicity, renal toxicity, bone marrow suppression, nausea and vomiting, abdominal pain and diarrhea in the observation group were significantly lower than those in the control group (χ2 value were 4.947, 4.893, 4.525, 4.692, 4.637, 4.905, respectively, all Ps<0.05). During the follow-up, the 1, 2 year survival rate in the observation group was higher than those in the control group (χ2 value were 3.782, 3.893, respectively, all Ps<0.05).@*Conclusions@#The Kangai-Guben-Xiaozheng decoction based on the theory of cancer pathogenesis, combined with TP regimen show effectiveness for the Ⅳ stage of ovarian cancer of the elderly patients.
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Objective In order to evaluate the clinical curative effect of Guizhi-Fuling pill combined with conventional therapy for the patients with oviduct obstructive infertility.Methods In this study,102 patients with oviduct obstructive infertility (OO1) that accorded with the inclusion criteria were randomly divided into two groups according to the order of treatment.During the study,a total of 5 patients were lost in the two groups,and so 49 in the treatment group and 48 in the control group completed the protocol.The control group was given fallopian tube recanalization under the hysteroscopy,and the treatment group was given oral Guizhi-Fuling pill at day 2 after surgery on the basis of the control group treatment.Both groups were observed for 6 months.Before and after treatment,TCM symptom score was conducted,and IL-6 level was determined by radioimmunoassay;the uterine fallopian tube was examined after the 6th month of treatment,and pregnancy rate was observed and recorded.Results After treatment,abdominal pain degree (0.6 ± 0.1 vs.1.3 ± 0.1,t=3.612),the low back pain (0.9 ± 0.2 vs.1.6 ± 0.2,t=2.553),abdominal distension (0.5 ± 0.0 vs.1.0 ± 0.8,t=2.364),menstrual blood clots (0.5 ± 0.1 vs.1.0 ± 0.1,t=2.331) in the treatment group were significantly lower than those in the control group (Ps＜0.05).After treatment,the rate of oviduct patency was 75.5％ (37/49) in thetreatment group,50.0％ (24/48) in the control group,and the comparison difference between the two groups was statistically significant (x2=8.075,P=0.044).After 6 months of treatment,the pregnancy rate of the treatment group was 63.3％ (31/49),and that of the control group was 37.5％ (18/48),the difference of pregnancy rate between the two groups was statistically significant (x2=6.724,P=0.035).After treatment,serum IL-6 (31.04 ± 2.47 ng/ml vs.42.71 ± 2.52 ng/ml,t=7.593) in the treatment group was signicantly lower than the control group (P＜0.05).Conelusions Guizhi-Fuling pill combined with conventional therapy can reduce IL-6 level,promote fallopian tube recanalization,improve the intrauterine pregnancy rate,and improve the clinical symptoms of OOI patients.
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Objective To investigate severe complications of inferior vena cava filter (IVCF) applying for preventing pulmonary embo-lism after spinal cord injury. Methods From December 2014 to July 2015, 95 patients with acute spinal cord injury (SCI) in our hospital were retrospected. Results Deep venous thrombosis (DVT) appeared in 23 cases, in which 15 cases placed IVCF. All patients accepted anti-coagulant therapy, except 10 cases with contraindication. 3 cases had severe complication, in which 2 cases had comprehensive DVT distal to IVCF, with both lower limbs severe swelling, acute renal inadequacy and hypertension;1 case had continuous hyperpyrexia. Conclusion Although the IVCF placement was widely used in acute SCI for preventing pulmonary embolism in patients with DVT, however, the selec-tion of IVCF and complication prevention should be taken into account.
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Objective To observe the effect of perioperative rehabilitation on anterior spinal cord syndrome caused by cervical hyper-flexion injury. Methods Sixty-nine inpatients with anterior spinal cord syndrome after cervical hyperflexion injury from January, 2012 to De-cember, 2014 were reviewed. 32 cases (group A) accepted systematic rehabilitations and other 37 cases (group B) did not. They were as-sessed with Japanese Orthopaedic Association (JOA) scores preoperatively and 1-year follow-up. Results All the patients succeeded in the operation. The JOA score improved more 1 year follow-up in group A than group B (t=2.538, P=0.044). Conclusion Systematic rehabilita-tion may work in the management of anterior spinal cord syndrome after cervical hyperflexion injury.
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@#Objective To study the mechanism, pathology, diagnosis and manage strategy of cervical fracture dislocation combined with anterior spinal cord syndrome (ASCS). Methods 32 cases of cervical fracture dislocation combined with ASCS from January 2012 to September 2014 were summarized. The mechanisms of injury and pathological characteristics were analyzed. All of them received surgical treatment. Anterior approach or anterior approach combined with posterior approach was chosen according to the characteristics of injury. Results All surgical treatments were successfully performed. There were 22 cases (68.75%) with hyperflexion, 5 cases (15.62%) with vertical hit, 1 case (3.12%) with hyperextension and 4 cases (12.5%) with multiple reasons. There were 4 cases (12.5%) with simple anterior dislocation, 28 cases (87.5%) with fracture combined with anterior dislocation. Only 8 cases were successfully diagnosed as ASCS, and the others (24 cases) were generally defined as spinal cord injury. Conclusion ASCS is not so rare. Hyperflexion injury is the most common mechanism. Anterior dislocation and fracture combined with anterior dislocation are the general types of pathology. Conscientious physical examination with CT and MRI can facilitate the diagnosis. Anterior approach or combined with posterior approach could be selected according to injury mechanism.
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Objective To study the mechanism, pathology, diagnosis and manage strategy of cervical fracture dislocation combined with anterior spinal cord syndrome (ASCS). Methods 32 cases of cervical fracture dislocation combined with ASCS from January 2012 to Sep-tember 2014 were summarized. The mechanisms of injury and pathological characteristics were analyzed. All of them received surgical treat-ment. Anterior approach or anterior approach combined with posterior approach was chosen according to the characteristics of injury. Re-sults All surgical treatments were successfully performed. There were 22 cases (68.75%) with hyperflexion, 5 cases (15.62%) with vertical hit, 1 case (3.12%) with hyperextension and 4 cases (12.5%) with multiple reasons. There were 4 cases (12.5%) with simple anterior disloca-tion, 28 cases (87.5%) with fracture combined with anterior dislocation. Only 8 cases were successfully diagnosed as ASCS, and the others (24 cases) were generally defined as spinal cord injury. Conclusion ASCS is not so rare. Hyperflexion injury is the most common mecha-nism. Anterior dislocation and fracture combined with anterior dislocation are the general types of pathology. Conscientious physical exami-nation with CT and MRI can facilitate the diagnosis. Anterior approach or combined with posterior approach could be selected according to injury mechanism.
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@#Objective To investigate the effect of comprehensive rehabilitation direction on functional ankle instability (FAI). Methods 32 consecutive patients with FAI were divided into 2 groups. The rehabilitation group (n=16) finished their rehabilitation program under the instruction of physiotherapists in the hospital, and the control group (n=16) exercised at home by written instruction. All the patients were tested with One Leg Standing Test (OLST) and Foot and Ankle Disability Index (FADI) for the injured ankle before and 4 weeks after training.Results The scores of both OLST and FADI improved after training in the rehabilitation group (P<0.01), but did not in the control group (P>0.05); and improved more in the rehabilitation group than in the control group (P<0.05). Conclusion The comprehensive rehabilitation direction is effctive on FAI.
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@#Objective To study the incidence of venous thromboembolism (VTE) between complete and incomplete spinal cord injured patients. Methods 177 cases of acute cervical spinal cord injury were observed from April 2007 to July 2010. According to ASIA classification, 52 cases of grade A involved in observation group, while 125 cases of grades B~D involved in control group. Intervention included low molecular weight heparin and rehabilitation training. Incidence of VTE in two groups was compared. Results There was 11 cases complicated with VTE in the observation group (21.2%) while 6 cases in the control group (4.8%). There was a difference in incidence of VTE between two groups (P<0.05). Conclusion There is a higher incidence of VTE in complete than incomplete cervical spinal cord injury
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@#Objective To investigate the effect of rehabilitation on cervical fracture-dislocation following spinal cord injury.Methods126 patients with cervical fracture-dislocation following spinal cord injury from August, 2002 to March, 2009 in our hospital had undergone cervical anterior surgical treatment. 22 cases were picked up as control group, who missed rehabilitation after surgery. 22 cases were chosen randomly from the rest of 104 cases as rehabilitation group, who had undergone rehabilitation. Prognosis was evaluated by Japanese Orthopaedic Association Scores score(JOA).ResultsFollow-up time was 8-32 months，mean time 18 months. The limb function of rehabilitation group improved significantly. JOA score and quality of life were much higher in rehabilitation group than in control group.ConclusionRehabilitation is very beneficial to improve the quality of life and prognosis, and reduce complications of patients with cervical fracture-dislocation following spinal cord injury at the early stage.
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@#Objective To study the influence of bleeding after using low molecular weight heparin （LMWH） to prevent deep vein thrombosis (DVT) in patients with thoracolumbar spinal bursting fracture and spinal cord injury operated by rear internal fixation. Methods 120 cases were divided into the observation group (64 cases) and control group (56 cases). The observation group accepted hypodermic injection of LMWH to prevent DVT, while the control group did not. Results The volume of bleeding and blood transfusion, the change of red blood cell count (RBC) and hemoglobin were compared between two groups before and after operation. There is no statistical significance. Conclusion During the period of the operation of rear internal fixation, low molecular weight heparin cannot increase the bleeding and is safe to prevent deep vein thrombosis.
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@#Objective To study the influence of bleeding after using low molecular weight heparin （LMWH） to prevent deep vein thrombosis (DVT) in patients with thoracolumbar spinal bursting fracture and spinal cord injury operated by rear internal fixation. Methods 120 cases were divided into the observation group (64 cases) and control group (56 cases). The observation group accepted hypodermic injection of LMWH to prevent DVT, while the control group did not. Results The volume of bleeding and blood transfusion, the change of red blood cell count (RBC) and hemoglobin were compared between two groups before and after operation. There is no statistical significance. Conclusion During the period of the operation of rear internal fixation, low molecular weight heparin cannot increase the bleeding and is safe to prevent deep vein thrombosis.
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Objective To study X-ray and CT methods of diagnosis of unilateral dislocation of the lower cervical vertebra(C_(3～7)).Methods 15 cases of the injury of unilateral dislocation of the lower cervical vertebra were reviewed from August 2002 to June 2008,X-ray and CT findings were observed.Results Lateral projection of X-ray showed:the anterior displacement of dislocated vertebra was less than 25% in 15 cases,the distance of posterior border of lateral mass of below vertebral body to line of neural scute changed rapidly in 13 cases,sign of "bow tie" of processus articularis superior in 12 cases.Antero-posterior projection showed that spinal process was lateral deviation.Oblique projection showed that intervertebral joints were dislocation or interlocking. CT showed:the "hamburger" sign were destroyed in 7 cases,fracture of unilateral articular process in 8 cases,rotation of vertebral body of dislocation and its superior vertebral body in 13 cases, "double ring" sign in 12 cases.Conclusion The signs of X-ray and CT in combination with the mechanism of injury and clinical situation,the unilateral dislocation of the lower cervical vertebra can be diagnosed accurately.
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@#Nogo receptor is specific inhibiting factor conjuncted with myelin of central nervous system(CNS).After spinal cord injury,oligodendroglial cell and Nogo-A released from myelin inside cells inhibited the axonal regeneration.To analyze the intervention for Nogo receptor through molecule outside cell,information inside cell and gene,make clearing the inhibiting action of myelin-associated inhibiting factor-1,provide new thoughts and methods about axonal regeneration after spinal cord injury.