Comparative Study on Treatment of Acute Gouty Arthritis by Electroacupuncture with Different Frequency

Objective: To study the therapeutic effect of treatment of acute gouty arthritis (AGA) respectively by electroacupuncture (EA) with different frequency and oral intake of Western medicine. Methods: Seventy-two patients of AGA were randomly assigned into three groups, 24 in each group. Group A was treated with EA 100 Hz; Group B with EA 2 Hz; and Group C with Western medicine. The analgesic effect, initiating time and sustaining time of analgesia were observed and the level of serum uric acid was measured before and after treatment. Results:The initiating time of analgesia was shorter while the sustaining time of analgesia was longer in Group A and B than those in Group C (all P<0. 01). The efficacy of analgesia was higher in Group B than that in Group A , and a better effect was shown in Group B in reducing serum uric acid level than that in Group A (P<0.01), which was near that in Group C (P>0.05). Conclusion: EA is an effective treatment for AGA, and low frequency (2 Hz) EA showed a better efficacy.     

Alleviation of Cancerous Pain by External Compress with Xiaozheng Zhitong Paste(消癥止痛方)

<正>Objective:To observe the clinical effectiveness of a topical application of Xiaozheng Zhitong Paste(消癥止痛方,XZP)in alleviating the cancerous pain of patients with middle/late stage cancer.Methods:By adopting a random number table,124 patients enrolled were randomized into the treatment group(64 patients) and the control group(60 patients).In addition to the basic therapy[including the three-ladder(3L)analgesia] used in both groups,topical application of XZP was given to patients in the treatment group for pain alleviation. The analgesic efficacy was recorded in terms of pain intensity,analgesia initiating time and sustaining time, and the optimal analgesic effect revealing time.Meanwhile,the quality of life(QOL)and adverse reactions that occurred in patients were recorded as well.Results:The total effective rate in the treatment group was 84.38%(54/64),and in the control group it was 88.33%(53/60),showing no significant difference between them(P0.05),but the analgesia initiating time and the optimal analgesia effect revealing time in the treatment group were significantly shorter(both P0.01).Moreover,XZP was better in improving patients' QOL,showing more significant improvements in the treatment group than those in the control group in aspects of mental condition,walking capacity,working capacity,social acceptability,sleep and joy of living(P0.05 or P0.01). Lower incidence of adverse reactions,such as nausea,vomiting,mouth dryness,dizziness,etc.,especially constipation,was noted in the treatment group(P0.05 or P0.01).Conclusion:Applying an external compress of XZP showed a synergistic action with 3L analgesia for shortening the initiating time and the optimal effect revealing time,and could evidently enhance patients' QOL with fewer adverse reactions.     

Treatment of Ankylosing Spondylitis with Medicated Moxibustion plus Salicylazosulfapyridine and Methotrexate——A Report of 30 Cases

To evaluate the therapeutic effect of medicated moxibustion plus administratuon ot salicylazosulfapyridine （SASP） and methotrexate （MTX） for treatment of active ankylosing spondylitis （AS）. Method： Ninety cases of active AS were randomly assigned to Group A, B and C （N=30 in each group）, and treated respectively with SASP and MTX, acupuncture plus SASP and MTX, and composite sulfur （tablet） moxibustion plus SASP and MTX for 3 successive courses （2 months each course with an interval of 5 days）. Results： Improvement in sacroiliitis index, Schober test, occipital wall test, finger-ground distance, as well as the erythrocyte sedimentation rate （ESR） and the content of C-reactive protein （CRP） in ＂Group B and C was far superior to that of Group A （P〈0.01）. Conclusion： Combined use of western medicine with acupuncture or with medicated moxibustion produces a better therapeutic effect than western medicine given alone.     

Effect of transcutaneous electrical acupoint stimulation on nausea and vomiting induced by patient controlled intravenous analgesia with tramadol

Objective： To observe the effect of transcutaneous electrical acupoint stimulation （TEAS） on nausea and vomiting （N＆V） induced by patient controlled intravenous analgesia （PCIA） with Tramadol. Methods： Sixty patients who were ready to receive scheduled operation for tumor in the head-neck region and post-operation PCIA, aged 39-65 years, with the physique grades Ⅰ -Ⅱ of ASA, were randomized into two groups, A and B, 30 in each group. The pre-operation medication, induction of analgesia and continuous anesthesia used in the two groups were the same. TEAS on bilateral Hegu （LI4） and Neiguan （PC6） points was intermittently applied to the patients in group A starting from 30 min before analgesia induction to 24 h after operation, and the incidence and score of nausea and vomiting, antiemetic used, visual analogue scores （VAS）, and PCIA pressing times in 4 time segments （0-4, 4-8, 8-12 and 12-24 h after the operation was finished） were determined. The same management was applied to patients in Group B, with sham TEAS for control. Results： The incidence and degree of N＆V, as well as the number of patients who needed remedial antiemetic in Group A were less than those in Group B. The VAS score and PCIA pressing time were lower in Group A than those in Group B in the corresponding time segments respectively. Conclusion： TEAS could prevent N＆V induced by PCIA with Tramadol.     

Comparison of the Effects of Electroacupuncture plus Cupping with That of the Electrical Pulse Therapy for Different Types of Cervical Spondylopathy

Objectives: To observe and compare the therapeutic effects of electroacupuncture (EA) plus cupping and the electrical pulse therapy on different types of cervical spondylopathy. Methods: 182 cases of cervical spondylopathy confirmed by X-ray or CT examination were divided into 4 types, and treated with EA plus cupping in Group A of 90 cases and with moderate or low electrical pulses in Group B of 92 cases. The therapeutic effects were compared after 3 courses of treatments. Results: For the vertebroarterial type and the nerve root type of cervical spondylopathy, the effect in Group A was better than that in Group B, while for the sympathetic type of cervical spondylopathy, the effect in Group B was superior to that in Group A.Conclusion: Appropriate therapies should be adopted for different types af cervical spondylopathy.     

Chinese Medicine for Outcomes in Colorectal Cancer Patients: A Retrospective Clinical Study

Objective: To investigate the effect of Chinese medicine(CM) on survival of patients with stage Ⅱ and Ⅲ colorectal cancer(CRC). Methods: A total of 295 patients who received chemotherapy were assigned to Group 1. The other 171 patients received the same chemotherapy treatment combined with the usage of CM Jianpi Jiedu Formula(健脾解毒方, JPJD) for more than 3 months(Group 2). Patients' survival time, relapse and metastasis, and cause of death were observed. Cox proportional hazard regression models were established for the analysis of the effect of independent factors on the survival prognosis of patients with CRC. Results: The survival rate of patients in Group 2 was higher than that of Group 1(P0.05). Compared with Group 1, the mean survival time was prolonged by 5.594 months and the median survival time was prolonged by 6 months in Group 2(P=0.004). Cox regression analysis indicated that CM combined with chemotherapy provided significant protective effect, as observed with the improvements in the survival rates of CRC patients(P0.01). Conclusion: CM can improve the survival rate in patients with stage Ⅱ and Ⅲ CRC.     

Patient-controlled intravenous fentanyl for cystospasm after transurethral resection of the prostate

Objective： To evaluate the clinical efficacy and safety of patient-controlled intravenous analgesia （PCIA） with fentanyl for cystospasm after transurethral resection of the prostate. Methods： Sixty benign prostatic hyperplasia （BPH） patients scheduled for transurethral resection of the prostate （TURP） under general anesthesia with laryngeal mask airway （LMA） were randomly divided into groups F and S. Group F （n=30） received PCIA device with fentanyl 10 ug/kg＋8 mg ondansetron, and Group S （n=30） received placebo （PCIA device with 8 mg ondansetron）. The visual analog scale （VAS） scores for pain were evaluated at 0, 2, 4, 8, 16, 24, and 48 h by the same staff. And recorded were incidence of cystospasm, side effects, application of hemostatic, duration of drawing Foley catheter and continuous bladder irrigation, time of exhaust after operation, time of post-operative stay and cost of hospitalization. Results： The incidence of cystospasm in Group F was significantly lower than that in Group S in the 48 h after operation （P〈0.05）, the VAS scores for pain in Group F was significantly lower than that in Group S within the 48 h after operation （P〈0.01）. The time of exhaust after operation in Group F was significantly later than in Group S （P〈0.05）. No significant difference was observed in applications of hemostatic, duration of drawing Foley catheter, duration of continuous bladder irrigation, time of post-operative stay and cost of hospitalization between the 2 groups. Conclusion： PCIA with fentanyl （10 ug/kg） relieves pain with little side effect and reduces cystospasm satisfactorily.     

Clinical study on the treatment of primary dysmenorrhea with preconditioning acupuncture

Objective:To observe the therapeutic effect of preconditioning acupuncture(PA) on the treatment of primary dysmenorrhea.Methods:Eighty patients suffered from primary dysmenorrhea were randomly assigned on the ratio of 1:1:2 into three groups,20 in Group A,20 in Group B,and 40 in Group C.Group A and B were treated with PA and immediate acupuncture(IA),respectively,while Group C received no acupuncture treatment and be taken as a blank control.The treatment was lasted for three menstrual cycles.The therapeutic effects were observed and compared.Results:Comparing the scores of the symptoms in the different groups, the therapeutic effect in different groups showed that the symptom scores in Group A at the second and third cycle of treatment,as well as at the first and third cycle of follow-up,were significantly lower than the scores in Group B,respectively(P<0.05 or P<0.01),and the duration of symptoms was shorter in Group A than in Group B at the third cycle of treatment and the first and third cycle of follow-up(P<0.05).Symptom scores in Groups A and B in the treatment and follow-up periods were all lowered as compared to those before treatment(P<0.01), and the scores were also lower than those in Group C measured at corresponding times(P<0.01).Conclusion: The therapeutic effect of PA,either the short-term or the long-term effect,was superior to that of IA in treating dysmenorrhea.     

Cohort Study on Prognosis of Patients with Metastatic Colorectal Cancer Treated with Integrated Chinese and Western Medicine

Objective: To investigate the efficacy of integrated Chinese and Western medicine(IM) in the treatment of metastatic colorectal cancer(m CRC) in a cohort study.Methods: The survival outcome of patients receiving IM was compared with that of patients receiving Western medicine alone.The study design was adopted with "continuous administration of Chinese medicine for 3 months" as the exposure factor.Patients who met this exposure factor were assigned to the IM cohort(Group A,110 patients).Patients who did not meet this exposure factor were assigned to the Western medicine cohort(Group B,225 patients).The overall survival(OS),progression-free survival(PFS),and 1 st year,2 nd year,and 3 rd year survival in the two cohorts were compared.Results: The median OS in Group A and B were 18 months [95% confidence interval(CI) 15–21] and 16 months(95% CI 14–18),respectively,and the median PFS in Group A and B were 6 months(95% CI 4–7) and 5 months(95% CI 4–6),respectively.No statistically significant differences were observed between the groups(P=0.186,P=0.223).Group A demonstrated significantly longer OS and PFS than Group B in the following subgroups: female patients,patients with lesions in the right half of the colon,and those who received first-line treatment(P0.05).In the subgroup of elderly patients(age65 years),the OS in Group A was longer than that in Group B(P0.05).Conclusion: IM could prolong the survival of patients with m CRC.(Registry No.Chi CTR-IOR-17010497)     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…