[Correlation between TCM syndrome types and clinical symptoms of benign prostatic hyperplasia with chronic prostatitis].

OBJECTIVE: To investigate the correlation between the syndrome types of traditional Chinese medicine (TCM) and clinical symptoms of benign prostatic hyperplasia (BPH) with chronic prostatitis (BPH-CP). METHODS: We selected 150 cases of BPH-CP in this study and divided them into 7 TCM syndrome types. Using univariate and multivariate logistic regression analyses, we studied the correlation of each TCM syndrome type with the age, disease course, prostate volume, postvoid residual urine volume (PVR), prostate-specific antigen (PSA) level, maximum urinary flow rate (Qmax), and International Prostate Symptoms Score (IPSS). RESULTS: Kidney-yin deficiency was correlated positively with the prostate volume but negatively with Qmax and IPSS; kidney-yang deficiency positively with the age and prostate volume but negatively with IPSS; the damp heat syndrome positively with the PSA level but negatively with the disease course, prostate volume and Qmax; the spleen-qi deficiency syndrome positively with the prostate volume but negatively with the disease course; liver-qi stagnation positively with the disease course but negatively with the age, prostate volume and PVR; the syndrome of qi stagnation and blood stasis positively with the disease course and IPSS but negatively with PVR; the syndrome of lung-heat and qi blockage positively with the age, Qmax and IPSS but negatively with the disease course. CONCLUSIONS: The TCM syndrome types of BPH-CP are closely correlated to their clinical symptoms. The analysis of the clinical objective indexes of BPH-CP can provide some reliable evidence for accurate identification of the TCM syndrome type of the disease.

Effects of Sisheng Decoction on the immunity and anti-stress function in mice with spleen deficiency syndrome.

OBJECTIVE: To study the possible mechanism of Sisheng Decoction on spleen deficiency syndrome via the observation of general conditions, immunity and anti-stress function in Dahuang (Radix et Rhizoma Rhei Palmati)-induced mice model. METHODS: Mice were randomized and grouped based on the body weight. The establishment of model and the treatment were done simultaneously. Except the mice in normal group, the decoction and the Dahuang powder were separately given in the morning and the afternoon for 14 d. The general condition of the mice, the rectal temperature, the time of burden swimming, the indexes of thymus and spleen and the interleukin-2 (IL-2) concentration in the serum were observed. RESULTS: The group treated with Sisheng Decoction showed better performance than that of the model group, including less stool, strong appetite and fast growth; the medium- and high-dose Sisheng Decoction increased the rectal temperature of mice. There was no statistical difference in the thymus and spleen indexes between the groups treated by Sisheng Decoction and the normal group (P>0.05). The thymus index in groups treated by sisheng Decoction was significantly elevated as compared with the model group (P<0.05). The medium- and high-dose Sisheng Decoction significantly improved the concentration of IL-2 and prolonged the time of burden swimming, as compared to the model group (P<0.05). CONCLUSION: The medium- and high-dose Sisheng Decoction is good at invigorating spleen and replenishing qi. One of the possible mechanisms may be related with the improvement of the immunity and anti-stress function of the body.

[Quantified diagnositic standard for large intestinal cancer of spleen qi deficiency syndrome.].

OBJECTIVE: To set a quantified diagnostic standard for large intestinal cancer of spleen qi deficiency syndrome. METHODS: The spleen qi deficiency syndrome was identified by experts on the basis of clinical epidemiological investigation of 311 patients suffering from large intestinal cancer. Corresponding points were assigned to the correlative factors (traditional Chinese medicine symptoms) on the basis of symptom differences between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome. The best threshold was determined by receiver operating characteristic curve (ROC) according to syndrome differentiation from expert team, and the quantified diagnostic standard was established. The syndrome identification from the expert team which was regarded as golden standard was tested retrospectively. RESULTS: All the traditional Chinese medicine symptoms possibly related to spleen qi deficiency syndrome were analyzed based on the opinions of experts, and 28 symptoms were confirmed as candidate correlative factors. The occurrence of 11 symptoms between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome showed statistical differences by means of crosstabs analysis (P<0.05). The 11 symptoms were filtered by logistic regression analysis, and tiredness, fatigue, loose stool, and poor appetite were finally determined as the symptoms relative to large intestinal cancer. These four symptoms were analyzed with conditional probability conversion and endowed with 16, 11, 4 and 8 points respectively. The diagnostic standard of spleen qi deficiency syndrome of large intestinal cancer was over 13 points. The sensitivity, specificity and accuracy of retrospective examination were all above 80%, and its positive likelihood ratio was 9.89. CONCLUSION: The quantified diagnostic standard for spleen qi deficiency syndrome of large intestinal cancer is in accordance with clinical characteristics of large intestine cancer and the characteristics of TCM syndrome diagnosis.

Splenic nodules in paediatric Gaucher disease treated by enzyme replacement therapy.

BACKGROUND: The natural history of focal splenic lesions in paediatric Gaucher disease (GD) is unknown and these lesions are thought to persist despite enzyme replacement therapy (ERT). OBJECTIVE: To assess the prevalence, evolution and resolution of splenic nodules in a cohort of paediatric Gaucher patients treated with ERT. MATERIALS AND METHODS: The US findings in 37 children with GD were retrospectively reviewed. A total of 28 children underwent serial abdominal US examinations as part of their initial assessment and during routine follow-up. All patients received ERT. RESULTS: Six children (21%) had splenic nodules on US examination, either at presentation or on follow-up examination. In all six patients, the nodules had resolved on follow-up imaging, with resolution taking 17 months to 4 years 8 months. Two sets of siblings developed nodules that resolved over a similar time period. CONCLUSION: Disappearance of focal splenic lesions in children with GD during follow-up has not been previously reported. The development of new focal splenic lesions in children with GD whilst on ERT has not been previously documented.

Intussusception up to splenic flexure by cecal carcinoma in an adult: report of a case.

A 73-year-old woman was admitted because of constipation and appetite loss. She was diagnosed as having intussusception caused by a colonic tumor, based on the results of physical examination and imaging such as ultrasonography, computed tomography and barium enema. Operation revealed that right colon from the cecum up to the hepatic flexure of the ascending colon was not fixed to the retroperitoneum, and a circular cecal carcinoma was invaginated to the splenic flexure of the transverse colon. We experienced a rare case of ileocolic intussusception up to the splenic flexure by a cecal carcinoma with mesenterium ileo-colicum commune in an adult.

Absceso esplénico: presentación de un caso y revisión de la literatura / Splenic abscess: presentation of a new case and review of the literature

Se presenta el caso de un paciente afecto de un absceso esplénico múltiple. Se trata de una patología poco frecuente, generalmente diagnosticada en estudios postmortem. Se discute la etiología, forma de presentación clínica, métodos diagnósticos y posibilidades terapéuticas, así como la necesidad de realizar diagnósticos precoces para iniciar pautas de tratamiento que permitan disminuir las altas tasas de mortalidad que tiene esta enfermedad (AU)

[Calcified splenic abscess, colonic fistula and ascites in a chronic carrier of Salmonella typhi]. / Abcès splénique calcifié, fistule colique et ascite chez un porteur chronique de Salmonella typhi.

We report the unusual case of a patient with chronic carriage of Salmonella typhi who presented with partially calcified splenic abscess linked to colic fistula and ascitis. The colic fistula could be secondary to ischemic necrosis by left colon compression due to spleen large abscess. Fistula was evidenced by abdominal computed tomography scan and confirmed by barium enema. The possible etiologies of ascitis are either tuberculosis or ascitic peritonitis secondary to the fistulisation; nevertheless, the role of segmentary portal located hypertension cannot be completely excluded. The splenic abscess was probably due to Salmonella typhi which was only isolated from stool specimens. The calcified splenic abscess was the evidence that the infection had occurred first. In addition, the isolation of Salmonella typhi in stool cultures six months after the subject had returned from the Comores proved the chronic carriage. Treatment by splenectomy and left colectomy was successful in this patient.

Magnetic resonance imaging of the spleen and pancreas.

MRI of the spleen and pancreas requires specialized sequences which diminish artifacts in the upper abdomen. High temporal resolution sequences (e.g., spoiled gradient echo) acquired immediately after intravenous Gd-DTPA administration are necessary for imaging both the spleen and pancreas. In evaluating the spleen, early post Gd-DTPA images are essential as many focal disease processes (e.g., lymphomatous deposits or metastases) equilibrate rapidly (< 2 min) with splenic parenchyma. Complete pancreatic examination also requires the use of T1-weighted fat suppressed spin echo. T2-weighted images provide complementary information in a number of settings, in particular in the evaluation of islet cell tumors. Pancreatic ductal carcinoma is low signal on T1-weighted images and enhances in a diminished fashion on immediate post Gd-DTPA images. These tumors are well differentiated from focal chronic pancreatitis and islet celltumors based on their appearances on combined T1, T2-weighted and immediate post Gd-DTPA enhanced images.

[Graduated quantitative diagnosis of spleen deficiency syndrome].

90 Cases with Spleen Deficiency Syndrome (SDS) in various diseases of different body system were studied to obtain a quantitative measurement of the syndrome for more accurate diagnosis. Rates of symptom manifestation of SDS, absorptivity of D-xylose, activity of salivary amylase, hemoglobin level, RBC count, plasma albumin, cardiac function as well as some parameters of hemorheology and lymphocyte transformation rate were observed. The results clearly showed that the D-xylose absorptivity was much lower in patients with higher appearance rate of SDS symptoms, which was dose-dependent. Along with the lowering of D-xylose absorptivity, the values of above-mentioned parameters dropped were positively correlated to it. On the contrary, the peripheral vascular resistance elevated as D-xylose absorptivity dropped. The author divided the SDS into three stages as a graduated quantitative diagnosis based on the drop of D-xylose absorptivity, the increase of SDS symptom and other changes of laboratory findings.

Torsion of the wandering spleen seen as a migratory abdominal mass.

Torsion of the wandering spleen is an unusual cause of an acute abdomen, rarely diagnosed preoperatively. The authors describe a case which was suspected prior to surgery and confirmed by radionuclide imaging. Radiographic findings include an extrinsic mass on barium-enema examination and absence of the splenic shadow in the left upper quadrant.