Traditional Chinese medicine together with high-dose vitamin C improves the therapeutic effect of western medicine against COVID-19.

OBJECTIVES: Traditional Chinese medicine has been reported to be effective in the treatment of epidemic diseases. Here, we aimed to investigate the effects of combined therapy of Chinese and western medicine on coronavirus disease 2019 (COVID-19). METHODS: A total of 60 patients diagnosed with COVID-19 were enrolled. Both the ordinary and severely affected patients were randomly divided into Groups A-C each with 10 cases each. The patients in Group A-C received Western medicine, Western medicine + traditional Chinese medicine, and Western medicine + traditional Chinese medicine + high dose of vitamin C, respectively. The time of disease recovery, symptoms disappearance, chest CT improvement, and tongue amelioration was recorded. Leukocyte, neutrophil and lymphocyte were monitored, as well as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalitonin (PCT), inflammatory factors, partial pressure of oxygen and carbon dioxide (PaCO2) and oxygenation index (PaO2). Urinary tract stones, liver function, and other side-effects such as gastrointestinal dysfunction were also investigated. RESULTS: Traditional Chinese medicine enhanced the effect of Western medicine, including the reduction of CRP, ESR, PCT, and inflammatory factors, and the increase of leukocyte, neutrophil, and lymphocyte counts, and the improvement of respiratory rate, PaO2, PaCO2, and oxygenation index. Traditional Chinese medicine combined with high-dose Vitamin C therapy more effectively shortened the time of disease recovery, symptom disappearance, chest CT improvement, and tongue amelioration. CONCLUSIONS: a combined therapy of Western medicine, traditional Chinese medicine, and high dose of Vitamin C results in a most effective outcome in the treatment of COVID-19.

Application of ultrasound during electrode implantation for sacral neuromodulation in patients with neurogenic bladder secondary to spinal cord disease: a retrospective study.

PURPOSE: To compare the use of intraoperative ultrasound with X-ray fluoroscopy during sacral neuromodulation lead electrode placement in patients with neurogenic bladder secondary to spinal cord disease. METHODS: We reviewed the medical records of 52 patients who underwent sacral neuromodulation (SNM) lead electrode implantation under fluoroscopy or ultrasound guidance from July 2016 to July 2019. The operating time, number of electrode contacts with stimulus responses, minimum voltage that causes a stimulus response, and rate of standard lead electrode placement were used to assess the differences between the two methods. All patients were evaluated by recording bladder diaries, postvoid residual volumes before and during the testing period. Permanent SNM implantation is acceptable if symptoms improve by at least 50%. RESULTS: The operating time decreased from 87.1 ± 25.19 min in the X-ray group to 68.2 ± 25.20 min (p < 0.05) in the ultrasound group. The number of electrode contacts with stimulus responses, rate of standard lead electrode placement, and implantable pulse generator (IPG) placement rate were not significantly different between the two groups (p > 0.05). There was no radiation exposure during the operation in the ultrasound group. No incisional infections, hematomas, or other critical complications were reported in either groups. CONCLUSION: Ultrasound can be applied to safely place lead electrode for sacral neuromodulation and leads to no radiation exposure to the patient, surgeon, and operating room staff and a shortened operating time while maintaining the same efficacy as X-ray.

[Clinical effects of high frequency repeated transcranial magnetic stimulation therapy on dyskinesia in patients with incomplete spinal cord injury:a Meta-analysis].

OBJECTIVE: To systematically evaluate the clinical effect of high frequency repeated transcranial magnetic stimulation(HF rTMS)therapy on dyskinesia in patients with incomplete spinal cord injury. METHODS: Randomized controlled trials(RCTs) about HF rTMS therapy on patients with motor incomplete spinal cord injury were searched electronically in PubMed, Google scholar, Cochrane library, Clinical trial, Medline, Web of science, CNKI, VIP, and Wanfang database before October 2016. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as extracted the data and assessed the methodological quality. The observed outcomes included ASIA motor score, ASIA lower extremities motor score(LEMS), Modified Ashworth score (MAS), Ten-meter walking test (10MWT) and Walking index for SCI II(WISCI II), and the outcomes were analyzed using RevMan5.2 software provided by the Cochrane information management system. RESULTS: Five RCTs involved 103 patients were included, and 61 patients(experimental group) accepted real rTMS and physical rehabilitation care for SCI, 51 patients(control group) accepted only physical rehabilitation care. There were significant differences in ASIA motor score, LEMS and 10MWT between two groups after HF rTMS therapy (statistics were Z=2.96, P=0.003; Z=3.04, P=0.002; Z=2.16, P=0.03; respectively). When stimulating the leg motor cortex, there was significant difference in MAS between two groups(Z=2.79, P=0.005), and when stimulating the vertex, there was no significant difference(Z=0.09, P=0.93). There was no significant difference in WISCI IIscore after HF rTMS therapy between two groups(Z=0.90, P=0.37). CONCLUSIONS: HF rTMS can raise motor score in patients with incomplete spinal cord injury, improve the spasticity of the lower extremities, and increase the motor ability.

Transforaminal endoscopic decompression for thoracic spinal stenosis under local anesthesia.

BACKGROUND: Thoracic spinal stenosis is a common vertebral degenerative disease, and treatment remains challenging. In recent years, transforaminal endoscopic decompression has been widely used for treating lumbar degenerative diseases. However, the efficacy of this procedure for thoracic spinal stenosis has yet to be established. Herein, we report a case of thoracic spinal stenosis treated with transforaminal endoscopic decompression under local anesthesia. CASE REPORT: An 88-year-old man presented with a 1-month history of progressive paralysis and dysesthesia in the bilateral lower extremities. A diagnosis of thoracic spinal stenosis was made, based on physical examination. A two-step percutaneous transforaminal endoscopic thoracic decompression was performed for spinal canal decompression. Over a follow-up of 1 year, a favorable outcome was noted. CONCLUSION: Transforaminal endoscopic decompression is a safe and an effective surgical approach for the treatment of thoracic spinal stenosis. For patients with thoracic spinal stenosis, accurate diagnosis and elaborate surgical planning should be highlighted, and the surgical outcome can be favorable.

Classification of gluteal muscle contracture in children and outcome of different treatments.

BACKGROUND: Gluteal muscle contracture (GMC) is a clinical syndrome due to multiple etiologies in which hip movements may be severely limited. The aim of this study was to propose a detailed classification of GMC and evaluate the statistical association between outcomes of different management and patient conditions. METHODS: One hundred fifty-eight patients, who were treated between January 1995 and December 2004, were reviewed at a mean duration of follow-up of 4.8 years. Statistical analyses were performed using X2 and Fisher's exact tests. RESULTS: Non-operative management (NOM), as a primary treatment, was effective in 19 of 49 patients (38.8%), while operative management was effective in all 129 patients, with an excellence rating of 83.7% (108/129). The outcome of NOM in level I patients was significantly higher than in level II and III patients (P < 0.05). The results of NOM and operative management in the child group were better than the adolescent group (P < 0.05). Complications in level III were more than in level II. CONCLUSION: NOM was more effective in level I patients than in level II and III patients. Operative management was effective in patients at all levels, with no statistical differences between levels or types. We recommend NOM as primary treatment for level I patients and operative management for level II and III patients. Either NOM or operative management should be carried out as early as possible.

[Study on effect of Xianzhong Injection on morphology of knee and insulin-like growth factor-1 in rabbits with early stage osteoarthritis].

OBJECTIVE: To investigate the effect of Xianzhong Injection (XI) on morphology of knee and insulin-like growth factor-1 (IGF-1) in rabbits with early stage osteoarthritis (OA). METHODS: One hundred and twenty rabbits were randomly divided into 5 groups, the blank group, the model group treated with 0.5 mL normal saline once a week, the positive control group treated with 0.5 mL hyaluronate once a week, and the XI 1 group and XI 2 group with 0.5 mL XI once and twice a week, respectively, all the medicines were medicated via intra-articular injection. Knee joint function was examined 8 weeks after modeling, IGF-1 content in serum and synovia was detected, and the histologic examination of articular cartilage was observed by Mallory staining as well. RESULTS: The improvement of knee joint function was better in the XI 1 and 2 groups than that in the model group (P < 0.01), and that in the XI 1 group was equivalent to that in the positive control group (P > 0.05). Histologic examination showed there was no calcification in all the layers of cartilage in the positive control group and the XI 1 group with complete cartilaginous bluish-green collagen preserved. The content of IGF-1 increased in synovia and serum in the positive control group and the two XI groups as compared with that in the model group (P < 0.05). CONCLUSION: XI can improve knee joint function to certain extent in early OA, and repair the degenerative cartilage.

Effects of xianzhong injection on the function of knee joint and the content of insulin-like growth factor-1 in rabbits of early osteoarthritis.

OBJECTIVE: To evaluate the effect of Xianzhong Injection into the articular cavity on the function of the joints and the content of insulin-like growth factor-1 (IGF-1) in rabbits with early knee osteoarthritis (OA). METHODS: 120 rabbits were randomly divided into five groups: blank group, model group (injecting 0.5ml of normal saline, once a week), positive control group (injecting 0.5ml of sodium hyaluronate, once a week), Xianzhong group I (injecting 0.5ml of Xianzhong Injection, once a week), Xianzhong group II (injecting 0.5ml of Xianzhong Injection, twice a week). Changes of the articular function and IGF-1 levels in the serum and joint fluid were investigated 8 weeks later. RESULTS: The function of knee joint in the Xianzhong group I and II was improved significantly as compared with that in the model group (P<0.01), and there was no significant difference between the Xianzhong group I and the positive control group (P>0.05), but a significant difference was seen between the Xianzhong group I and the Xianzhong group II (P<0.05); in the positive control group, the Xianzhong group I and the Xianzhong group II , the levels of IGF-1 in the joint fluid and serum were significantly increased as compared with that in the model group (P < 0.01). CONCLUSION: Xianzhong Injection can improve the function of knee joint in rabbits with early knee OA, and can substitute sodium hyaluronate Injection for treating this disease.

[Clinical observation on effect of gufusheng capsule in treating early stage Legg-Calve-Perthes disease].

OBJECTIVE: To evaluate the clinical efficacy of Gufusheng capsule (GFSC) in treating early stage Legg-Calve-Perthes disease. METHODS: Adopting randomized single controlled trial, 45 cases with Legg-Calve-Perthes disease in early stage were randomly divided into 2 groups, 23 patients in the control group were treated with arthrectomy hip synovial membrane excision of affected lateral, femoral head decompression and transplantation of muscle-bone flap from ileum, above treatment were also given to the 22 patients in the treated group but combined with orally taking of GFSC. The treatment course for both groups was 6 months. RESULTS: Short-term effect after 6 months' treatment showed that the total effective rate in the treated group and the control group was 90.9% and 78.3% respectively, and the excellent rate was 72.7% and 60.9% respectively. The pain visual analogue scoring, clinical symptom and syndrome scoring markedly decreased before and after treatment, showing significant difference between the two groups (P < 0.05, P < 0.01). Long-term effect after 1-year to 4-year follow-up showed that the total effective rate and excellent rate between the treated group and the control group was significantly different ( chi2 = 8. 5976, P < 0.05). CONCLUSION: GFSC has marked effect in alleviating pain and ameliorating function of hip joint, being an effective compound recipe for treatment of early stage Legg-Calve-Perthes disease. Therefore, it is worthy of researching and developing furthermore.

Experimental study on gufusheng in treatment of steroid-induced ischemic necrosis of femoral head in rabbits.

OBJECTIVE: To explore the mechanisim of compound Gufusheng in treatment of steroid-induced ischemic necrosis of femoral head (SINFH). Thirty-two rabbits were randomly divided into a blank control group (n=12) and a model group (n=20). The rabbits of the model group were established by intramuscular injection of prednisone acetate (0.32mg/kg/d) for 8 weeks, and 2 rabbits in each group were killed at the 6th and the 8th week respectively to investigate whether the model was successfully prepared. Then remainder in the model group was again randomly divided into group A (Gufusheng group, n=8) and group B (model group, n=8), while the rest of rabbits in the blank group constituted group C (n=8). The rabbits in group A were given Gufusheng Decoction by intragastric perfusion, and the rabbits in group B and C were fed with normal saline. After treatment for 4 weeks, the serum insulin-like growth factor-1 (IGF-1) and tumor necrosis factor-alpha (TNF-alpha) levels in the rabbits of the 3 groups were determined by radioimmunoassay (RIA). The serum TNF-alpha decreased significantly and the IGF-1 level increased significantly in the Gufusheng group as compared with the model group (both P<0.01). Compound Gufusheng can prevent SINFH and promote repair of the tissue of necrosis of femoral head possibly via decreasing the TNF-alpha and increasing IGF-1 level.

Effects of bushen huoxue decoction on nitric oxide (NO) in serum, articular cartilage and synovium in rabbits of knee osteoarthritis.

UNLABELLED: Forty-eight New Zealand rabbits were divided into normal group (n=18), control group (n=18) and Chinese herbs treatment group (n=12) randomly. The rabbits in the normal group received sham-operation, and the OA model was established by Hulth's method. All the rabbits in the treatment group were given bushen huoxue decoction from the 6th week after the operation. At 6th, 8th and 12th week after the operation, the NO concentrations of the serum, joint cartilage and synovium were examined. RESULTS: Indicated that the NO concentrations of the serum, joint cartilage and synovium in the control group were all significantly higher than those in the normal group, with the joint cartilage more obvious (P<0.05). In the Chinese herbs treatment group the NO concentrations in all the parts obviously decreased as compared with the control group (P<0.05). It is suggested that bushen huoxue decoction decrease the levels of NO in the serum, synovium and joint cartilage in the OA rabbit.