The endoscopic evaluation of gastritis,gastric remnant residue,and the incidence of secondary cancer after pylorus-preserving and transverse gastrectomies

Background Pylorus-preserving gastrectomy (PPG) and transverse gastrectomy (TrG) have been accepted as function-preserving procedures for node-negative early gastric cancer. It is believed that a better quality of life is guaranteed after PPG or TrG compared to that after distal subtotal gastrectomy (DSG) with Billroth type-I reconstruction. However, objective evaluations of the gastric remnant following gastrectomy have not been widely reported, and the real advantages and disadvantages of PPG or TrG over DSG remain unclear. Moreover, the risk of secondary cancer after PPG or TrG is uncertain.Methods Between 1991 and 2000, 834 DSGs were carried out in our institute for preoperatively diagnosed patients with early gastric cancer. The degree of residual gastritis and the amount of diet residue in the gastric remnant were evaluated by annual gastrointestinal endoscopic investigations prospectively for 72 patients after PPG, 95 patients after TrG, and 60 patients after DSG. These analyses were performed using the RGB classification (residue, gastritis, bile). The incidence of disease greater than or equal to grade 2 was calculated, and the time trends of the incidence for each procedure were also studied for 3 years after gastrectomy. In addition, secondary cancer cases in the gastric remnant mucosa were checked for each procedure during this period, and the incidence of secondary cancer after each operation was calculated.Results The incidence of gastritis, of grade 2 or more, found in the gastric remnant was significantly lower after PPG (1.4%) and TrG (2.1%) than after DSG (43.3%). However, the incidence of moderate or greater residue in the gastric remnant, grade 2 or more, was significantly higher after PPG (45.8%) and TrG (40.0%) than after DSG (11.7%). The analysis of time trends of gastritis and diet residue reflected the significant advantage or disadvantage for each procedure 1 year after surgery. The analysis also included these factors without consideration of elapsed time following surgery. Two patients after PPG (2.8%) and three patients after TrG (3.2%) developed secondary cancer in the gastric remnant. No DSG-treated patient showed new cancer genesis in the remaining stomach.Conclusion PPG and TrG have the advantage over DSG in preventing postoperative gastritis in the gastric remnant. On the other hand, moderate or greater diet residue in the gastric remnant is more common after PPG or TrG than after DSG. For the risk of carcinogenesis in the remnant gastric mucosa, we could not conclude that there was any apparent difference between these range-limited gastrectomies and conventional DSG. Further study is necessary to determine the significant advantages and disadvantages of using PPG or TrG.     

Efficiency of adjuvant immunochemotherapy following curative resection in patients with locally advanced gastric cancer

Background Despite curative resection, 50%–90% of gastric cancer patients die of disease relapse. Although some clinical trials have indicated that chemotherapy and immunochemotherapy may be effective modalities, more recent studies have not been able to define the standard treatment for advanced gastric cancer. The present study evaluated the effect of adjuvant immunochemotherapy with the use of BCG (bacille Calmette-Guérin) and FAM (5-fluorouracil, adriamycin, mitomycin C) chemotherapy on the survival of patients with locally advanced resectable gastric cancer.Methods A total of 156 patients with stage III or IV gastric cancer who had undergone curative resection were randomly assigned to three treatment groups: BCG + FAM (immunochemotherapy), FAM (chemotherapy), and control (surgery only). Treatment was continued for 2 years or until death. Further postsurgical follow up was carried on for up to 10 years.Results Overall 10-year survival was 47.1% for the immunochemotherapy group (P < 0.037 vs FAM and P < 0.0006 vs control), 30% for the chemotherapy group (vs control, NS), and 15.2% for the control group. In patients with pT2/T3 primary tumors, 10-year survival was 55.3% for BCG + FAM vs 28.2% for FAM (P < 0.01) and 14.6% for the control group (P < 0.00018). BCG + FAM signifi-cantly improved the survival of patients with intestinal-type but not diffuse-type cancer. Immunochemotherapy was well tolerated.Conclusion This study, based on a limited number of patients, indicates that adjuvant immunochemotherapy (BCG + FAM) may prolong the survival of gastric cancer patients after curative gastrectomy; in particular, in patients with pT2/T3 tumors and intestinal-type primary tumors. There was no survival benefit from FAM adjuvant chemotherapy.     

Prostatosis treated with acupuncture and herbal medicine

According to differentiation of symptoms and signs, prostatosis was divided into pattern of dampness and heat in the lower energizer, pattern of qi stagnation and blood stasis, pattern of deficiency and cold in the lower abdomen, and pattern of qi deficiency and kidney deficiency. Prostatosis were treated mainly by acupuncture, plus moxibustion and Chinese medicine, and the effect was good. Author: Zhao Chang-quan (1949-), male, junior consultant doctor Translator: Huang Guo-qi     

Acupuncture treatment of 32 cases of lumbar intervertebral disc protrusion

Yaoyangguan (GV 3), Shiqizhui (Ex-B 8) and Yanglingquan (GB 34) were selected as main points and a three-part needle insertion technique was used to treat 32 cases of lumbar intervertebral disc protrusion. The curative rate was 96.9%. Deep puncture is the key to the treatment. Author: Chen Feng(1962-), male, junior consultant doctor Translator: Wang Si-you     

Kneading manipulation

In the performance of rubbing manipulation, because of the fingers comparatively light vertical pressure and large-range circular movement, the palm and fingers cannot adhere to the patient's skin, and the relative friction movement.     

Clinical observation of vascular dementia treated by surrounding-acupuncture of the CT-located area

Purpose To observe the clinical effect of “Surrounding Needling Technigue through CT Location” in treating vascular dementia.Method Fifty cases of vascular dementia were randomly divided into surrounding Needling Technigue through CT location and routine acupuncture groups, 25 cases in each group, and were given surrounding Needling Technigue through CT location and routine acupuncture respectively.Results The effective rates in surrounding Needling Technigue through CT location and routine acupuncture groups were 88% and 60% respectively, and there was significant difference between the two groups,P<0.01.Conclusion Therapeutic effect of surrounding Needling Technigue through CT location in treating vascular dementia was satisfactory, and better than that of routine acupuncture. Foundation Item: Scientific Fundation of Guangdong TCM Bureau Author: Lun Xin(1964-), male, associate professor     

Clinical observation on treatment of 60 cases of osteoarthritis of knee joint by electroacupuncture

Purpose To observe therapeutic effect of electroacupuncture Neixiyan (Ex-LE 4) and Dubi (ST 35) in treating osteoarthritis of knee joint.Method All the 120 cases were randomly divided into electroacupuncture and control groups, 60 cases in each group, and they were given electroacupuncture and Ritalin slowreleased tablet respectively, and pain, mobility and swelling degree of knee joint were observed before and after treatments.Results In treatment group, the average score increased by 18, while in control group, it increased by 12.33 (P<0.05) after treatment.Conclusion Therapeutic effect of electroacupuncture Neixiyan (Ex-LE 4) and Dubi (ST 35) in treating osteoarthritis of knee joint was better than that of administration of Ritalin slow-released tablet. Author: DAI Qi-ping (1966-), female, attending physician Translator: Wu Xue-fei     

Patterns of apoplectic dysarthria and acupuncture treatment

In accordance with the feature of apoplectic dysarthria, it is divided into three types of labial pattern, lingual pattern and laryngeal pattern. The therapeutic methods are respectively explained with case examples. Translator: HUANG Guo-qi     

Treatment of vascular dementia by acupuncture: A review

Related to treatment of senile dementia, 53 articles conformed the statistical demand were analyzed, finding commonly used methods are acupuncture, moxibustion, acupoint-injection, electro-acupuncture, ocular-acupuncture, scalp-acupuncture, digital-acupuncture and acupuncture plus other therapies, key treatment principle is opening orifice and invigorating brain, frequent selected acupoints are Baihui (GV 20), Zusanli (ST 36), Fengchi (GB 20), Fenglong (ST 40), Neiguan (PC 6), Shuigou (GV 26), etc; and the total effective rate is 89.62%. Author: HUANG Qin-feng (1951-), female, associate professor