Therapeutic Effect of Jinlongshe Granule (金龙蛇颗粒) on Quality of Life of Stage Ⅳ Gastric Cancer Patients Using EORTC QLQ-C30: A Double-Blind Placebo-Controlled Clinical Trial

Objective: To evaluate the impact of Jinlongshe Granule (金龙蛇颗粒, JLSG) on quality of life (QOL) of stage Ⅳ gastric cancer patients. Methods: This randomized, double-blind and placebo-controlled clinical trial included 50 patients with advanced gastric cancer. They were equally randomized into a JLSG group and a placebo group. Patients in both groups received routine Chinese herbal decoctions according to Chinese medicine (CM) treatment based on syndrome differentiation. Patients in JLSG group received additional JLSG, and those in the placebo group received an additional placebo. In the JLSG group, 19 patients who completed the study were used for analysis. In the placebo group, finally the data of 20 patients who completed the study were used for analysis. The treatment course was at least 3 months, and the follow-up duration was at least 6 months in 5 interviews. Repeated measurements of the subscale items and individual items in European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 (EORTC QLQ-C30) obtained at the 5 interviews were compared using different patient groups, changes over time and changes within one group over time independently to observe the tendency of changes in the scores. Results: Using time as the variant, there was significant difference in 4 functional scales (physical, role, emotional and social, P<0.05), 3 symptom scales (fatigue, nausea and vomiting and pain, P<0.05) and a global health status/QOL scale (P<0.05) and 6 single symptoms dyspnoea (P>0.05), insomnia (P<0.05), appetite loss (P<0.05), constipation (P<0.05), diarrhea (P>0.05) and financial difficulties (P<0.05). There was also significant difference in these items between the two groups when the placebo group and group over time were used as variants (P<0.05 or P<0.01). Conclusion: Additional use of JLSG on the basis of routine CM treatment could improve the somatic function, role function, emotional function, social function, cognitive function and general QOL of patients with advanced gastric cancer, and relieve the symptoms of fatigue, nausea and vomiting, pain, loss of appetite and constipation.     

丙泊酚加氯胺酮全麻联合经鼻气管插管行小儿扁桃体切除52例

小儿扁桃体切除,较大儿童可采用局麻,但大部分患儿不能配合需行全身麻醉,而单纯全麻,手术时间长,出血多时,又易致患儿误吸.我院2007-2009年,对扁桃体切除术的患儿采用丙泊酚加氯胺酮静脉麻醉联合经鼻气管插管行小儿扁桃体切除术,效果满意,现报告如下.     

胃癌不同证型的性别构成比较分析

笔者2002年11月-2004年5月收集297例原发性胃癌患者,分析胃癌不同证型的性别构成差异,现报道如下：     

低浓度罗哌卡因复合芬太尼用于分娩镇痛的临床观察

我院自2007年1月至2010年3月应用1.14%甲磺酸罗哌卡因用于分娩镇痛同时与未用任何镇痛措施的初产妇进行比较,现将观察结果报告如下.     

丙泊酚加氯胺酮全麻联合经鼻气管插管行小儿扁桃体切除52例

小儿扁桃体切除,较大儿童可采用局麻,但大部分患儿不能配合需行全身麻醉,而单纯全麻,手术时间长,出血多时,又易致患儿误吸。     

Tumor interstitial fluid and gastric cancer metastasis: An experimental study to verify the hypothesis of “tumor-phlegm microenvironment”

Objective:To extract tumor interstitial fluid(TIF) from MKN-45 gastric cancer which is similar to "muddy phlegm" in Chinese medicine and observe influences of MKN-45 tumor interstitial fluid(MKN-45 TIF) intervention on metastasis of gastric cancer and on the expressions of vascular endothelial growth factor(VEGF), kinase insert domain containing receptor(KDR),epithelial-cadherin(E-cad),cyclooxygenase-2(COX-2),intercellular adhesion molecule-1(ICAM-1) and telomerase genes and proteins in primary tumor tissue.Methods:An MKN-45 tumor-bearing model was established in 50 nude mice.The modeled animals were equally randomized to 5 groups: the simple tumor-bearing group(model group),the normal saline(NS) via tail vein injection(i.v.) group(NS i.v. group),MKN-45 TIF i.v.group(TIF i.v.group),NS intraperitoneal injection(i.p.) group(NS i.p.group),and MKN-45 TIF i.p.group(TIF i.p.group).The TIF and NS intervention groups received injection(i.p.or i.v.) of MKN-45 TIF or NS twice a week,0.2 mL at a time.After 8 weeks,the primary tumors were removed,weighed and HE stained to observe tumor metastasis.The primary tumor tissues were analyzed by immunohistochemistry and real-time quantitative PCR to detect expressions of VEGF,KDR,E-cad,COX-2,ICAM-1,and telomerase genes and proteins in different groups.Results:There were significant differences in tumor weight between TIF intervention groups and the model and NS intervention groups.Tumor metastasis was observed in all 5 groups,but the tumor metastasis rate in TIF intervention groups was significantly higher than those in the model and NS intervention groups.The gene and protein expressions of gastric cancer-related factors VEGF,KDR,COX-2,ICAM-1 and telomerase were unregulated while the gene and protein expressions of E-cad were downregulated in TIF intervention groups. Conclusions:TIF promotes tumor growth,invasion and metastasis of gastric cancer.These findings provide preliminary experimental clues for verifying the hypothesis of "tumor-phlegm microenvironment".     

异丙酚用于人工流产术811例临床观察

目的评价异丙酚静脉麻醉下人工流产术的临床效果,探讨其术中管理最佳方案.方法对811例ASAⅠ～Ⅱ级,妊娠6～11周无心肺等病史的孕妇.首次予异丙酚2mg/kg,以0.15～0.20ml/秒静脉推注.必要时追加异丙酚30～50mg.术中常规吸氧,监测诱导前、后2min及术毕的BP、HR及SaO2等指标,并观察睫毛反射消失及术后呼之睁眼时间.结果给药1.2±0.2min后睫毛反射消失,8.1±2.2min后呼之睁眼.BP及SaO2诱导前均显著高于诱导后2min(P＜0.05);HR无显著性差异(P＞0.05);诱导前与术毕比较BP、SaO2及HR均无明显差异(P＞0.05).结论异丙酚用于人工流产起效快、作用时间短、苏醒迅速、药效确切安全,有利于宫口松弛.但对心血管及呼吸系统有一定抑制作用,术中应常规吸氧、监BP、HR及SaO2,术前可不常规给药.     

以取象比类法研究胃癌痰本质

通过取象比类的研究方法,将胃癌痰浊壅盛的临床主症作为主要证型进行研究,加之其迁延不愈、术后易复发且痰证加剧的临床表现,形象比拟"蘑菇论""蓝藻论",构建胃癌痰证假说,架构胃癌痰证理论。再依从胃癌痰证假说,进行临床和实验的双重验证,以病辨证、以方测证、以证治法验证痰证的物质基础存在,形成系统性的胃癌痰本质研究。     

魏品康教授以升阳益胃法治疗发热伴淋巴结肿大1例

魏品康教授为主任医师、博士研究生导师,从事临床工作40余年。临证注重辨证论治,在治疗疑难病时,注意根据疾病不同发展阶段运用辨证论治灵活潜方用药。笔者有幸随师诊治1例发热伴淋巴结肿大的患者,魏教授通过辨证论治,以升阳益胃汤治疗,取得良效。现将案例介绍如下。