Clinical observation on treatment of post-craniocerebral traumatic mental disorder by integrative medicine

Objective： To observe the clinical efficacy of integrative medical therapy in treating post-craniocerebral traumatic mental disorder （PCT-MD）. Methods： Sixty patients with confirmed diagnosis of PCT-MD were randomly assigned to the treated group and the control group equally. All were treated by conventional comprehensive Western medicine, but to patients in the treated group, modified Xufu Zhuyu Decoction （血府逐瘀汤, XFZY） was additionally given and the therapeutic course for both groups was 20 days. Changes in mental symptoms were observed and recorded on the 10th and 20th day and clinical efficacy as well as cranial CT image was estimated after termination of the treatment. Results： The clinical effective rate in the treated group and the control group was 96.67% and 83.30% respectively. Comparison between them showed significant difference （P〈0.05）. Significant differences were also shown in the comparisons between the two groups in improving mental symptoms, either on the 10th or on the 20th day （P〈0.05 and P〈0.01 respectively）, and in post-treatment cranial CT image （P〈0.05）. Conclusion： Better efficacy could be obtained by integrative medical therapy in treating PCT-MD.     

Clinical observation on the efficacy of Xiaoshui decoction (消水方) combined with intrapleural perfusion of cisplatin in treating malignant pleural effusion

Objective： To observe the clinical efficacy of Xiaoshui decoction （XSD,消水方） combined with intrapleural perfusion of cisplatin in the treatment of malignant pleural effusion. Methods： Fifty-one patients with malignant pleural effusion were randomly assigned to two groups. The treated group patients） received oral administration of XSD combined with intrapleural perfusion of cisplatin, and control group （25 patients） was only treated with intrapleural perfusion of cisplatin. The effects of 26 he he short-term efficacy, quality of life scores and clinical symptom scores of malignant pleural effusion were evaluated. Results： The short-term efficacy in the treated group and the control group was 72.0% and 58.3%, respectively, and no significant difference was found （P〉0.05）. In contrast, the quality of life in the treated group was significantly improved compared to that of the control group （P〈0.05）, and so was the symptom remission （P〈0.05）. Conclusions： The combined therapy of XSD and intrapleural perfusion of cisplatin did not show obvious improvement in short-term efficacy, but the therapy remarkably alleviated the symptoms and improved the quality of life of patients.     

Clinical Effect of Fuzheng Jiedu Granule (扶正解毒颗粒) on Serum NO,NOS and Microelements in Patients with Coronary Heart Disease in Long-term Contact with Nickel

Objective: To study the clinical effect of Fuzheng Jiedu granule (扶正解毒颗粒, FJG) and its influence on serum nitric oxide (NO), nitric oxide synthase (NOS) and rnicroelements in patients with coronary heart disease who are in long-term contact with nickel. Methods: Sixty patients were randomly divided into two groups, the treated group and the control group, 30 in each group. Conventional Western medicinal treatment was applied to both groups, but to the treated group, FJG was given additionally by oral intake, and the therapeutic course for both groups was 4 weeks. Besides, a health control group was set up with 15 healthy subjects selected from the same area, who had no history of contact with nickel. Clinical symptoms of the patients and changes in their electrocardiogram (ECG) and serum levels of NO, NOS and microelements were observed before and after treatment. Results: The total effective rate on clinical symptoms in the treated group was 93.3% and that in the control group 63.3%, comparison between the two showing significant difference (P＜0. 05); the total effective rate on ECG in the two groups was 90.0% and 56.7% respectively, which also showed significant difference ( P＜0. 05). After treatment, levels of serum NO, NOS, Mg, Zn and Ca increased and those of Ni, Mn and Fe decreased significantly ( P＜0. 05 or P＜0.01) in the treated group, while in the control group, changes in these laboratory indexes were insignificant. Conclusion: FJG could lower the blood nickel level and regulate the unbalance of microelements, help restore serum NO and NOS in persons exposed to nickel and improve the clinical symptoms of patients with coronary heart disease and in long-term contact with nickel.     

Clinical Observation on Effect of Kaixin Capsule （开心胶囊） in Treating 40 Patients with Diabetic Myocardial Ischemia

Objective： To observe the effect of Kaixin Capsule （开心胶囊, KXC） on myocardial ischemia and plasma endothelin （ET） level in patients with diabetic heart disease （DHD）. Methods： The 72 subjects for observation were randomly selected from inpatients whose diagnosis fit to the standard of DHD. The 32 patients allocated in the control group were treated with conventional Western medicine, and the 40 patients in the treated group were treated with conventional Western medicine in combination with KXC, with the therapeutic course for both groups as 60 days. Results： On ECG, the total effective rate and markedly ef- fective rate in the treated group was 85. 0% and 37. 5% respectively, higher than those in the control group＇s 68.7% and 28. 1% respectively, and showing significant difference between the two groups （P〈 0.05）. The level of ET in patients in both groups was significantly higher than normal range, after treatment, but reduced to different extent, and the comparison between them also showed that the difference was significant （P〈0.05）. Conclusion： KXC might, by way of inhibiting and blocking the release of ET, lower its level in plasma so as to improve the myocardial ischemic condition of patients with DHD.     

Application of kushenin on patients with chronic hepatitis C after renal transplantation

Objective： To evaluate the efficacy of kushenin in treating patients with chronic hepatitis C after renal transplantation. Methods： Fifty-five patients were randomly assigned by lottery to the treatment group （29 cases） and control group （26 cases）. The same immunosuppression therapy was given to all patients in both groups. Patients in the treatment group were treated with kushenin 0.6 g once a day, while those in the control group were treated with conventional liver protective agents such as vitamins. The treatment duration of both groups was 3 months. The incidences of serious hepatitis and acute rejection reaction, serum biochemistry parameters including indicators of liver and kidney functions, hepatic fibrosis index, and serum HCV-RNA were compared between the two groups. Results： （1） The incidence of serious hepatitis in the treatment group and the control group was 3.45% （1/29 cases） and 11.54% （3/26 cases）, respectively, which was insignificantly different between the two groups （P=0.335）. （2） The incidence of acute rejection in the treatment group was 6.90% （2/29 cases） and that in the control group was 7.69% （2/26 cases）, showing insignificant difference （P=0.335）. （3） The differences in serum alanine aminotransferase （ALT）, direct bilirubin （DBIL）, hyaluronic acid （HA）, propeptide collagen type Ⅲ （PC Ⅲ）, laminin （LN）, collagen type Ⅳ（Col Ⅳ） levels between the two groups were insignificant before transplantation （P〉0.05）, while the above-mentioned parameters in the treatment group were significantly lower than those in the control group after transplantation （P〈0.05）. The difference in serum creatinine （SCr） and endogenous creatinine clearance rate （CCr） between the two groups was insignificant before and after transplantation （P〉0.05）. （4） The negative conversion rate of HCV-RNA in the treatment group was 31.03% （9/29 cases）, significantly higher than the value of 11.54% （3/26 cases?     

Clinical observation on the treatment of chloasma by Chinese herbs combined with acupuncture

Objective:To evaluate the clinical effect of Chinese herbs combined with acupuncture (CH-A) in treating chloasma.Methods:Sixty-one patients with chloasma were randomly assigned to two groups:30 in the control group and 31 in the treated group.Both groups received conventional treatment with oral intake of vitamin C and E,and external application of Quban Powder (祛斑散). Besides,the treated group also received CH-A,with the therapeutic course for both groups as 3 months.Results:The total effective rate in the treated group and the control group was 100.00% and 46.67% respectively,and the cure-effective rate was 74.19% and 13.33% respectively,all showing significant difference between the two groups (P<0.01).The scores of size and color of skin lesion and that of symptoms decreased in both groups,but the decrease in the treated group was more obvious, showing significant difference compared with those before treatment and also compared with those in the control group after treatment (P<0.05 or P<0.01).A follow-up study in 1 year to 2 years and 4 months showed that the long-term effect in the treated group showed an increasing trend compared with the effect immediately after treatment,but it showed a decreasing trend in the control group,though with no any statistical significance (both P>0.05).Conclusion:On the basis of conventional treatment, combined use of Chinese herbal medicine and acupuncture in treating chloasma could markedly improve the accompanied symptoms,lighten the color and shrink the size of skin lesions.     

Effect of Tiaozhi Yanggan Decoction (调脂养肝汤) in treating patients with non-alcoholic fatty liver

Objective:To observe the clinical efficacy and safety of Tiaozhi Yanggan Decoction (调脂养肝汤,TZYGD)in treating non-alcoholic fatty liver.Methods:One hundred and thirty-eight patients were enrolled and randomized into two groups according to the random number table in a ratio of 3:1,with 8 cases eventually dropping out.The symptoms,signs,liver function markers, blood lipids,iconographic indices and clinical comprehensive efficacy after a 12-week treatment course were assessed in 101 patients treated with TZYGD in the treated group and 29 patients treated with Thiola in the control group.Results:The total effective rate in the treated group and the control group was 81.19% and 68.97%,respectively,showing a significant difference between the two groups with the former being significantly higher than the latter(P<0.05).Moreover,the improvements in the symptoms,signs,liver function,blood lipids and iconographic indices in the treated group were favorable with no serious adverse reactions.Conclusion:TZYGD is effective and highly safe in treating non-alcoholic fatty liver.     

Comparative Study on the Efficacy of Yiweining （异位宁） and Gestrinone for Post-operational Treatment of

Objective： To observe the clinical efficacy and safety of Yiweining （异位宁, YWN） and gestrinone （GT） in treating post-operational patients of stage Ⅲ endometriosis （EM-Ⅲ）. Methods： Fifty-two patients of EM-Ⅲ after operation were randomly assigned into three groups, the YWN group （20 patients） was treated through oral intake of YWN 200 ml, twice a day; the GT group （19 patients） treated with gestrinone 2.5 mg, twice every week, with the medication starting from the 7th post-operational day and lasting for 6 months. The control group （13 patients） was untreated. Six months was one therapeutic course, and follow-up study was carried out in the 6-30 months after the end of the medication. Results： The recurrence rate in the YWN group and the GT group were 5.0% and 5.3% respectively, showing insignificant difference between the two groups, but they were lower than that in the control group （30.7%, P〈0.05）. Besides, the adverse reaction rate in the YWN group was lower than that in the GT group （ 10.0% vs 31.6%, P〈 0.05）. Conclusion： Application of YWN to prevent the post-operational recurrence of endometriosis is effective and safe, and its efficacy is similar to that of GT.     

Clinical observation on the treatment of chronic urticaria with total glucosides of paeony capsule combined with citirizine

<正>Objective:To assess the effect and adverse reaction of total glucosides of paeony capsule(TGPC)in combining with citirizine for the treatment of chronic urticaria.Methods:A total of 120 patients were assigned to two groups by lottery,65 in the treated group and 55 in the control group.They all were orally treated with citirizine tablet 10 mg per day,but to the treated group,additional 0.2 g TGPC was given three times per day,the therapeutic course for both groups was 4 weeks.The effectiveness of treatment was observed,and the changes of total symptom score,serum levels of interleukin-4(IL-4),and immunoglobulin E(IgE)were measured before and after treatment.Moreover,a followup was carried out one month after ending the treatment.Results:The dropped cases were two in the treated group and seven in the control group;so,the study was accomplished on 63 patients in the treated group and 48 patients in the control group.The total effective rate was assessed at 73.02%(46/63)in the treated group,which was significantly higher than 47.92%(23/48)in the control group(P0.01).After treatment,the total symptom score decreased in both groups,but the decrement in the treated group was more significant(P0.05).Serum levels of IL-4 and IgE in the treated group lowered significantly,while the changes in the control group were insignificant,so statistical significant differences were shown between groups(P0.01).A follow-up study showed that the relapse rate in the treated group was 30.00% (6/20),while that in the control group was 90.00%(9/10),and the former was lower than the latter(P0.01).Adverse reactions,revealed as drowsiness,dizziness,and weakness,were seen in eight cases and seven cases in the two groups,respectively.Besides,mild diarrhea occurred in two cases of the treated group.Condusioiis:The treatment of TGPC combining citirizine shows definite curative effect in treating chronic urticaria,with low relapse rate and without evident adverse reaction.Its therapeutic effect might be realized by means of regulating patients' immune function. Besides,the medication should be continued for a rather long period to achieve the full effect.     

Clinical observation on treatment of depression by electro-acupuncture combined with Paroxetine

Objective:To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture (EA) in treating depression.Methods:Forty-two patients with depression were randomly assigned to the observation group (22 patients) treated with EA combined with Paroxetine,and the control group (20 patients) treated with Paroxetine alone,and the therapeutic course for both groups was 6 weeks.The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale (HAMD) and treatment emergent symptoms scale (TESS), respectively.Results:HAMD scores determined at the end of the 1st,2nd,4th,and 6th week of the treatment course were significantly lower in the observation group than those in the control group (P<0.05).The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group (72.7% vs 40.0%).No significant difference of TESS scores was found between the two groups.Conclusion:EA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone,with milder adverse reaction and quicker initiation of effect.     

Clinical Observation on Treatment of Acute Gouty Arthritis byTongfengkang(痛风康)

Objective To objectively evaluate the clinical therapeutic effect of Tongfengkang (TFK) in treating acute gouty arthritis. Methods: Adopting randomized single blinded controlled trial, the 40 patients were equally divided into two groups. The tested group was treated with TFK, the control group was treated with indomethacin and allopurinol, the therapeutic course for both groups was 10 days. Results: The clinical cure rate in the tested group and the control group was 30% and 35% respectively, and the total effective rate 90% and 95% respectively, with no significant difference between the two groups (P>0.05).The scores of blood uric acid and symptom significantly lowered in both groups after treatment (P <0.01), but showed no significant difference between them (P>0.05). Adverse reaction to the treatment was shown in 3 patients in the control group. Conclusion: The therapeutic effect of TFK is similar to that of indomethacin plus allopurinol but with less adverse reaction, it is an effective and safe re     

Study on clinical effect and mechanism of Jianpi Qingre Huayu Recipe (健脾清热化瘀方) in treating patients with gastric ulcer

Objective： To study the effects of Jianpi Qingre Huayu Recipe （健脾清热化瘀方, JQH） in curing gastric ulcer and to preliminarily probe into its pathogenic mechanism, Methods： Fifty patients with gastric ulcer of Pi （脾）-insufficiency and stasis-heat syndrome type were assigned to the treated group （30 patients） and the control group （20 patients）. They were treated respectively with JQH and Ranitidine. At the same time, another group consisting of 20 healthy persons was set up for normal control. The clinical effect on gastroscopic figure and traditional Chinese medicine （TCM） syndrome were observed. Changes of T-cell subsets and interleukin-8 （IL-8） in serum as well as IL-8 in mucosa around the gastric ulcer were determined before and after treatment by flow cytometry and ELISA. Results： Comparison of the total effective rate on gastroscopic figure in the treated group and the control group （86.7% vs 80.0%） showed insignificant difference, but the cure rate and markedly effective rate in the former （50.0% and 20.0%） was higher than that in the latter （40.0% and 15.0%） respectively. Comparison of the total effective rate on TCM syndrome in the treated group and in the control group （96.7% vs 70.0%） showed insignificant difference, but the cure rate and markedly effective rate in the former （63.3% and 23.3%） was higher than that in the latter （50.0% and 20.0%） respectively. Serum levels of CD3^＋, CD4^＋, CD8^＋ got restored to normal range in the treated group after treatment but it was not so in the control group. IL-8 level in gastric mucosa was improved in both groups but the improvement in the treated group was better. Cenclusien： JQH could effectively treat gastric ulcer and partly reduce its recurrence through improving patients＇ immune function.     

A Randomized Trial of Chinese Medicine Lirukang Granule (利乳康颗粒) Combined with Psychological Intervention for Cyclomastopathy and Menoxenia

Objective:To observe the influence of therapy with Chinese medicine Lirukang Granule（利乳康颗粒）,LRKG) combined with psychological intervention on anxiety states and sex hormones in patients with cyclomastopathy and menoxenia.Methods:A total of 470 subjects were randomly assigned to three groups by the net-central randomization system,the treatment group（161 patients,treated with LRKG and psychological intervention）,the Chinese medicine group（157 patients,treated with LRKG）,and the psychological intervention group（152 patients,treated with psychological intervention）.The dose of LRKG was 12 g three times per day; psychological intervention included establishing relations,cognitive intervention and psychological persuasion, 30-40 min per session,once a week.The therapy duration for all groups was three months.The efficacy was compared and anxiety state/State-Trait Anxiety Invertory（STAI） scoring was measured before and after treatment.The serum estradiol（E₂）,progesterone（P）,prolactin（PRL） and follicle stimulating hormone（FSH） levels of 60 patients selected randomly from each group during the luteal phase were measured before and after treatment,and a group of 20 healthy women were evaluated for comparison.A follow-up was arranged for one year after treatment.Results:Thirty subjects were lost to follow-up.（1） Comparison of efficacy:the markedly effective rate and the total effective rate of the treatment group were 86.67%（131/150） and 98.00%（147/150）, respectively;of the Chinese medicine group,64.58%（93/144） and 90.27%（130/144）,respectively;and of the psychological intervention group,0%（0/146） and 3.42%（5/146）,respectively.The markedly effective rate and the total effective rate in the treatment group were significantly higher than those in the Chinese medicine and psychological intervention groups（P<0.05）.（2） Comparison of STAI scoring:STAI scoring was decreased dramatically in the treatment group after treatment compared with that of the Chinese medicine group（P<0.01）, but there was no significant difference compared with the psychological intervention group.（3） Comparison of levels of sex hormones:E₂,P,PRL and FSH of the three patient groups were disordered before treatment,and significantly different from healthy women（P<0.01）.After treatment,the levels of P and FSH of the treatment group were significantly increased（P<0.01）,E₂ and PRL were significantly reduced,which were also significantly decreased compared with the psychological intervention groups（P<0.01）.（4） Follow-up:the markedly effective rate and the total effective rate of the treatment group remained higher than those of the other two groups after one year of treatment（P<0.05）.（5） Adverse reactions:no obvious adverse reactions were found among the three groups.Conclusions:Therapy with Chinese medicine combined with psychological intervention was effective for short-term and long-term treatment of cyclomastopathy and menoxenia.The mechanism might be related to the regulation of sex hormones.     

Two-year Observation of the Clinical Efficacy in Treating Chronic Hepatitis B Patients with Ganxian Recipe(肝纤方) and Lamivudinene

Objective:To evaluate the clinical efficacy of Ganxian recipe (肝纤方, GXR) and lamivudine (LVD) in a two-year treatment of chronic hepatitis B (CHB). Methods: One hundred and twenty patients with CHB were randomly divided into the combinedly treated group (combined group) of 40 CHB patients who were treated with GXR combined with LVD. Another 40 CHB patients were treated with LVD alone (WM group), and still another 40 CHB patients were treated with GXR alone (TCM group). All these cases were randomly controlled and observed for two years. Results: Comprehensive efficacy: Total effective rate of the combined group (complete response and partial response) was 92. 5 %, while that of the WM group was 67.5 % and TCM group 57.5 %, respectively, with the difference between them was significant (P＜0.01);after treatment, the hepatic functions (AST, ALT, SB) of the three groups were all reduced, and the reduction in the combined group was particularly significant in comparison with the WM group or TCM group, P＜0.05 or P＜0.01 respectively, suggesting that the effect in the combined group was better than that in the other two groups; the rate of tyrosine-methionine-aspartate-aspartate (YMDD) virus mutation: it was 7.5%in the combined group, 40.0% in the WM group, and 5.0% in the TCM group; liver fibrosis improvement parameter: after treatment, the results in the combined group got better than those in the other two groups.Conclusion: GXR could inhibit the appearance of YMDD after long-term application of LVD, and combined use has marked synergism.     

Clinical effect of Sidong Wubu method in treatment of closed fracture of upper limbs

OBJECTIVE:To objectively evaluate the clinically curative effect of sidong wubu method on closed fracture of upper limbs.METHODS:A single-blind randomized controlled trial was used to divide 654 patients with closed fracture of upper limbs at early stage into two groups.298 patients in the surgical group were treated with open reduction and internal fixation and 356 patients in the treatment group with sidong wubu method for 6 months as a course of treatment.RESULTS:As for short-term curative effect(after 6 courses of treatment),the total effective rate was 97.7% in the treatment group and 92.9% in the control group,and the excellent and good rate was 83.7% and 76.5% respectively.Fracture-healing time,treatment cost,function-recovering time,scores of symptoms and signs obviously declined in both groups with remarkable difference between the two groups.As to long-term curative effect(after follow-up visit for one year to 5 years and 2 months),there was still noticeable difference(χ 2 = 7.536,P<0.05) in total curative effect and in excellent and good rate between the two groups.CONCLUSION:With low cost,short treatment course,good function and other advantages,sidong wubu method can be first used to treat closed fracture of upper limbs.     

Clinical study on treatment of mammary cancer by Shenqi Fuzheng Injection (参芪 扶正注射液) in cooperation with chemotherapy

Objective： To study the effect of Shenqi Fuzheng Injection （参芪扶正注射液,SFI） on cellular immune in patients with mammary cancer （MC） after chemotherapy. Methods： One hundred and ten patients with MC were randomly assigned to two groups. The 58 patients in the tested group were treated with SFI in cooperation with chemotherapy of CAF protocol （Cyclophosphamide, Doxorubicin and Fluorouracil）, while the 52 patients in the control group were treated with chemotherapy of the same protocol alone. Changes of the patients＇ quality of life （QOF）, adverse reaction that occurred, peripheral lymphocyte count and killing activity of single karyocyte before and after treatment between the two groups were compared. Results： Patients＇ QOF elevating rate after treatment in the tested group and the control group was 34.5% and 13.5% respectively; The lowering of peripheral blood cell count of WBC, platelet and lymphocyte as well as that of the killing activity of single peripheral karyocyte on various kinds of MC cells were all milder and recovery sooner than those in the control group. Conclusion： SFI in combination with chemotherapy in treating MC could reduce the occurrence of adverse reaction to chemotherapy, improve clinical symptoms, elevate QOF and enhance immunity in patients with MC.     

Randomized controlled trial on treatment of bronchial asthma of qi-deficiency cold syndrome type by Pingchuan Yiqi Granule (平喘益气颗粒)

Objective： To evaluate the effect and safety of Pingchuan Yiqi Granule （平喘益气颗粒, PYG） in treating bronchial asthma of qi-deficiency cold syndrome type （BS-QDC）. Methods： With the randomized, positive agent parallel controlled design adopted, the 80 subjects enrolled were assigned in the ratio of 3：1 to two groups, the 60 patients in the trial group were treated with PYG and the 20 in the control group treated with Ruyi Dingchuan Pill （如意定喘丸,RDP）, with the therapeutic course consisting of 7 days for both groups. The clinical effects, effects on TCM syndrome and the changes of lung function after treatment were observed. Results： The effect of the treatment on asthma in the trial group： clinically controlled rate was 6.67%, markedly effective rate 51.67%, improved rate 33.33% and ineffective rate 8.33%; and the corresponding rates in the control group were 5.00%, 50.00%, 30.00%, and 15.00% respectively. Comparison between the two groups showed insignificant difference （P〉0.05）. The effect on TCM syndrome in the treated group： clinically controlled rate was 11.67%, markedly effective rate 58.33%, effective rate 21.67% and ineffective rate 8.33%; and those in the control group were 10.00%, 50.00%, 30.00% and 10.00% respectively, also showing insignificant difference between the two groups （P〉0.05）. Lung function test showed that the change on forced expiratory volume in 1 second （FEV1） after treatment in the trial group was of statistical significance （P〈0.05）, but no significant difference was shown in the change of peak expiratory flow （PEE P〉0.05）; while the changes in the control group were just the opposite, showing insignificance in FEV1 （P〉0.05） but significance in PEF （P〈0.05）. Comparison of the therapeutic effect on lung function between the two groups showed no significant difference （P〉0.05）. No adverse reaction was found in either group in the course of treatment. Conclusion： PYG used to treat BS-QDC is effective and safe, it＇s effect is similar to that of RDP.     

Efficacy and safety of combined therapy with terazosin and tolteradine for patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: a prospective study

Background The primary objectives of the treatment for the lower urinary tract symptoms （LUTS） associated with benign prostatic hyperplasia （BPH） are to produce rapid, sustained, and safe improvements in the symptoms that affect the quality of life in the majority of men over 50. In this study, we evaluated the efficacy and safety of the combined therapy with terazosin （α1-adrenergic receptor antagonist） and tolterodine （anticholinergic agent） for LUTS associated with BPH. Methods This combination study included 69 patients diagnosed with LUTS associated with BPH based on the International Prostate Symptom Scores （IPSS）, urinary flow rate, prostate volume, urinary residual, and their serum prostate-specific antigen levels. Initially, 191 patients were treated with terazosin 2 mg once daily for one week. Those patients with continued LUTS after the initial treatment were allocated randomly into two groups： terazosin group （n=-36） in which patients were treated with terazosin 2 mg once daily for six weeks, and combination group （n=33） in which patients were treated with both terazosin 2 mg once daily and tolterodine 2 mg twice daily for 6 weeks. Results The IPSS were significantly improved in both groups after treatment, and the reduction of IPSS in the combination group was significantly greater than that in the terazosin group （P〈0.01）. A decrease in urgency, frequency and nocturia were the main contributory factors causing the reduction of IPSS in the combination group. The differences about the peak urinary flow rate and the residual urine from the baseline values were noted in both groups after treatment but were not significant between the two groups. The incidence of adverse effects in the combination group was higher than that in the terazosin group. As expected the most common adverse effect was mouth dryness which was associated with anticholinergic drugs such as tolterodine. Conclusions Patients with LUTS associated BPH appear the improved IPSS after combined therapy with terazosin and tolterodine. This study, although short term and limited numbers of patients, provides evidence that the combined therapy with terazosin plus tolterodine is a good approach for meeting the objectives of rapid, sustained, and safe improvements in the LUTS associated with BPH. And the profile of patients in this study might be used as the indication of such combined therapy for LUTS associated with BPH without urodynamic evaluation.     

Dynamic Radiographic Analysis of Sympathetic Cervical Spondylosis Instability

Objective To investigate the correlation between subaxial cervical spine instability and cervical spondylotic sympathetic symptoms as well as the difference of cervical spondylotic subaxial instability between male and female patients. Methods We analyzed retrospectively 318 surgical cases of cervical spondylosis treated at Department of Orthopedic Surgery of Peking Union Medical College Hospital between July 2003 and December 2007. All cases were divided into group A without sympathetic symptoms （n=284） and group B with sympathetic symptoms （n=34）. Angular and horizontal translation values between two adjacent vertebral bodies from C2 to C7 were measured separately on hyperflexion and hyperextension lateral cervical spine radiographs. Fisher＇s exact test was used to evaluate the correlation between subaxial cervical instability and sympathetic symptoms. Intragroup correlation between patient gender and subaxial cervical instability was also evaluated. Results Subaxial instability incidences in groups A and B were 21.8% （62/284） and 55.9% （19/34）, respectively. Statistical analysis indicated a definite correlation between subaxial cervical instability and sympathetic symptoms （P=0.000）. Among patients without sympathetic symptoms, subaxial instability incidences were 21.4% （37/173） in males and 22.5% （25/111） in females, respectively （P=0.883）. While among patients with sympathetic symptoms, sub axial instability incidences were 27.3% （3/11） in males and 69.6% （16/23） in females, respectively, indicating significant difference （P=0.030）. Subaxial instability was most commonly seen at C4-C5 intervertebral space in sympathetic cervical spondylosis patients. Conclusions High correlation exists between subaxial cervical spine instability and cervical spondylotic sympathetic symptoms, especially in female patients. Hyperextension and hyperflexion radiographs of cervical spine are important to assess sympathetic cervical spondylotic subaxial instability.     

Treatment of advanced non-small cell lung cancer with extracorporeal high frequency thermotherapy combined with Chinese medicine

Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell lung cancer. Methods： The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM （the treatment group）, the other only with CM （the control group）. The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate （DCR） and time to progression （TTP）. Secondary endpoints were overall survival time and 1-year survival rate. Results： Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease （28.8%）, while the DCR of the control group was 63.3%, and 11 had progression of disease （36.7%）; there was a significant statistical difference （P0.05）, suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time （MST） of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP （P0.05）, but no difference on MST or 1-year survival rate. Conclusion： EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.