Improving Effect of Modified Buyang Huanwutang Combined with Electroacupuncture on Traumatic Spinal Cord Injury due to Qi Deficiency and Blood Stasis / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Buyang Huanwutang combined with electroacupuncture （EA） in the treatment of traumatic spinal cord injury （TSCI） due to Qi deficiency and blood stasis. Method:Eighty-seven TSCI patients who met the inclusion requirements were randomly divided into an observation group （<italic>n</italic>=44） and a control group （<italic>n</italic>=43）. On the basis of comprehensive western medical treatments， patients in the control group were further provided with Wuwei Tongshuan oral liquid，10 mL per time，three times per day， while those in the observation group received modified Buyang Huanwutang，one bag per day，for 12 consecutive weeks. Besides， EA was performed in both groups in the same way， once per day， six times per week， for six weeks in total. The American Spinal Injury Association （ASIA） motor score， modified Barthel index （MBI），visual analog scale （VAS） pain score，Berg balance scale （BBS） score，modified Ashworth scale （MAS） score， spinal cord independence measure-Ⅲ（SCIM-Ⅲ） score， lower limb range of motion （ROM）， and Qi deficiency and blood stasis syndrome score before and after treatment were evaluated， followed by the recording of the occurrence of complications during treatment. The brain-derived nerve growth factor （BDNF）， nerve growth factor （NGF）， vascular endothelial growth factor （VEGF）， neurotrophic factor-3 （NT-3）， malondialdehyde （MDA） and superoxide dismutase （SOD） levels before and after treatment were determined. Result:The motor， light touch， needling sensation， MBI， and BBS scores of the observation group were higher than those of the control group （<italic>P</italic><0.01）， while the AS and MAS scores were lower（<italic>P</italic><0.01）. The angles of adductor and straight leg raising in the observation group were greater than those of the control group （<italic>P</italic><0.01），but the Qi deficiency and blood stasis syndrome score was lower（<italic>P</italic><0.01）. Both the scores of self-care， respiration， and sphincter management in SCIM-Ⅲ and the total score in the observation group were elevated as compared with those of the control group （<italic>P</italic><0.01）. The cumulative incidence of complications in the observation group was 34.09%，significantly lower than 55.81% in the control group （<italic>χ</italic>²=4.149，<italic>P</italic><0.05）. Compared with the control group， the observation group exhibited remarkably increased BDNF， NGF， VEGF， NT-3， and SOD （<italic>P</italic><0.01） and decreased MDA （<italic>P</italic><0.01）. Conclusion:Modified Buyang Huanwutang combined with EA is effective in alleviating spinal cord injury， promoting neural functional recovery， improving independence in activities of daily living， reducing the incidence of complications of patients with TSCI， which may be related to the amelioration of ischemia and hypoxia， inhibition of lipid peroxidation， and acceleration of nerve cell repair and regeneration.

Reduced irradiation target volume of mediastinal lymph node drainage in conformal radiotherapy for patients with non-small cell lung cancer after thoracic surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To decrease lung and esophageal radiation injuries by reducing irradiation target volume of mediastinal lymph mode drainage in conformal radiotherapy (CRT) for patients with non-small cell lung cancer (NSCLC) after thoracic surgery.</p><p><b>METHODS</b>Fifty-three patients with NSCLC were randomized into groups A and B to receive 3D-CRT after thoracic surgery. Patients in group A, according to conventional therapy, received preventive nodal irradiation (PNI) of the mediastinal lymph node drainage, and those in group B, according to pathological nodal staging after operation, did not have PNI of the metastasis-free area to reduce the clinical target volume (CTV). Patients in both groups were treated with conventional fractionated radiotherapy (CFRT) at 2 Gy in each fraction, and 5 fractions each week. All patients were followed up for two years to record their 2-year survival rate, local relapse of lymph node drainage and lung and esophageal radiation injuries.</p><p><b>RESULTS</b>The total 2-year survival rate was 58.5%in these patients and comparable between the two groups. The rates of local regional relapse and recurrence out of the CTV were 13.8% and 3.4% in group A and 16.7% and 8.3% in group B, respectively (P=1 and P=0.571). The incidence of radiation pneumonia and lung fibrosis were 6.9% and 62.1% in group A and 0% and 58.3% in group B (P=0.459 and P=0.782), and that of radiation esogphagitis and esophagus stricture rates were 27.6% and 6.9% in group A and 12.5% and 4.2% in group B, respectively (P=0.039 and P=1).</p><p><b>CONCLUSION</b>Reduced CTV does not warrant decrease in the local control but may lower the incidence of acute esophageal radiation injury in postoperative patients with NSCLC.</p>

Relationship between radiosensitivity of nasopharyngeal carcinoma and MDR1 gene polymorphism / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between human multidrug resistancel gene (MDR1) polymorphisms and the radiosensitivity of nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>Blood samples were collected from 59 NPC patients, who were devided into radiosensitive or radioresistant groups according to their responses to radiation therapy. The genotypes for MDR1 polymorphisms (G2677T in exon 21 and C3435T in exon 26) and their haplotypes were determined by PCR and restriction fragment length polymorphism analysis. The results were further confirmed by sequencing.</p><p><b>RESULTS</b>The 3435CC genotype was associated with a significantly better response to radiotherapy than combined 3435 CT and TT genotype (P=0.026). The 2677GG genotype was also associated with a better response in comparison with combined 2677 GT and TT genotype, but this relation was not statistically significant. Patients with 2677G-3435C haplotype had a significant better response to radiotherapy than those with the other haplotypes (P=0.017).</p><p><b>CONCLUSION</b>The MDR1 G2677T and C3435T polymorphisms may help predict the response to radiotherapy in NPC patients.</p>