Comprehensive Treatment Group Research Articles

Clinical study on the treatment of Qingfei Paidu Granules combined with nondrug therapy for asymptomatic patients with novel coronavirus.

The COVID-19 pandemic, ongoing for over 2 years with evolving viral strains, including the highly infectious Omicron variant, underscores the pivotal role of Traditional Chinese Medicine (TCM) in pandemic intervention. Qingfei Paidu Granules (QFPG) are incorporated into the national TCM diagnosis and treatment protocol. This study aims to assess the clinical effectiveness of QFPG combined with nonpharmacological interventions in asymptomatic novel coronavirus infection. Using a full-group randomized controlled trial, asymptomatic individuals from 3 wards of Fangcang Hospital were randomly assigned to 3 groups, each comprising 150 cases: F1, the nonpharmacological treatment group, receiving only Five Elements Music Therapy and Gongfa Therapy; F2, the comprehensive treatment group, receiving QFPG treatment combined with Five Elements Music Therapy and Gongfa Therapy; and F3, the pharmacological treatment group, receiving only QFPG treatment. The treatment duration for each group was 6 days. Clinical efficacy and safety among different treatment groups were observed, including the conversion time of COVID-19 nucleic acid detection, duration of hospitalization, conversion rate from mild to moderate cases, and occurrence of adverse events. All 450 participants were included and completed the study. The conversion rates on the first day of treatment were 10.7%, 30%, and 11.3% for the F1, F2, and F3 groups, respectively. Compared to F1, both F2 and F3 showed shortened first conversion time and time to double negative results, with first conversion times of 1.92 days for F2 and 2.29 days for F3. Additionally, the time in F2 was shorter compared to F3. Hospitalization duration was shortened in both F2 and F3 compared to F1, with no statistically significant difference between F2 and F3. The conversion rate from mild to moderate cases was lower in both F2 and F3 compared to F1, but the difference between F2 and F3 was not significant. Combining QFPG with traditional Chinese nonpharmacological interventions effectively shortened the conversion time of COVID-19 nucleic acid detection and reduced the conversion rate from asymptomatic infection to mild/moderate cases. This treatment approach is worth promoting in the management of asymptomatic patients during pandemics. ClinicalTrials.gov, ChiCTR2200059007.

Evaluation of visual perceptual training-assisted far-infrared nanomaterial-based eye relaxation system combined with chinese medicine therapy to control myopia in adolescents

This study investigated the efficacy of the far-infrared eye relaxation system assisted visual perceptual training (VPT) combined with auricular point sticking (APS) in myopia. Fifty-two adolescent myopic patients were randomly divided into the comprehensive intervention and control groups. The control group received optometry therapy, whereas the comprehensive treatment group received VPT combined with APS and supplemented with an eye relaxation system. The zinc oxide and silica nanoparticles used in the eye relaxation system could maintain good stability in acid and alkali, and had a considerable bactericidal effect. After treatment, patients in the comprehensive intervention group showed significant improvements in ocular accommodation, visual acuity, and diopter. Furthermore, the growth rate of the axial length and intraocular pressure were significantly controlled, while lens thickness decreased and eye fatigue improved. Thus, the combination of VPT and APS shows great potential in the myopia therapy.

Analysis of therapeutic effect of high focused extracorporeal shock wave comprehensive therapy on femoral head bone marrow edema syndrome

Purpose: This study explored the clinical therapeutic effect of high-focused extracorporeal shock wave therapy (HF-ESWT) combined with exercise rehabilitation and drug therapy on femoral head bone marrow edema syndrome (BMES). Materials and Methods: This study systematically reviewed and analyzed the clinical data of 43 patients with femoral head bone marrow edema who were treated in our hospital from January 2017 to June 2022. Twenty-three patients received HF-ESWT comprehensive treatment. Twenty patients received general treatment including medication and exercise rehabilitation treatment. The treatment methods for Group B patients were the same as Group A, except for not receiving shock wave therapy. Changes in visual analog scale (VAS), Harris score of the hip, and the edema area of region of interest area (ROIA) on hip magnetic resonance imaging (MRI) were analyzed before and after treatment. Results: Our research found that patients receiving HF-ESWT had significantly reduced VAS compared with general treatment at 1, 2, and 3 months (P < 0.05). We found that HF-ESWT comprehensive treatment had significantly improved hip Harris score compared with general treatment at 2 and 3 months (P < 0.05). HF-ESWT comprehensive treatment had significantly reduced edema area of ROIA on hip MRI compared with general treatment at 1, 2, and 3 months (P < 0.05). In addition, the healing rate was significantly higher in the HF-ESWT comprehensive treatment group compared with general treatment group (P < 0.05). One of the patients in the group treated with shockwaves developed hip pain that worsened after treatment, three patients developed local skin ecchymosis, and the other patients had no adverse events. Conclusion: HF-ESWT comprehensive treatment significantly reduced hip pain symptoms, quickly shortened the time for femoral head edema to dissipate, and significantly improved hip function for affected limbs with bone marrow edema syndrome. HF-ESWT comprehensive treatment may be an effective therapeutic strategy for HF-BMES. Keywords: Extracorporeal shock wave therapy, Bone marrow edema syndrome, Traditional Chinese medicine, Osteonecrosis of the femoral head

Autologous Shuffling Lipo-Aspirated Fat Combined Mechanical Stretch in Revision Rhinoplasty for Severe Contractures in Asian Patients.

A severely contracted nose is a common occurrence. Intraoperative expansion is not sufficient to soften the severely constricted nasal envelope, which poses challenges in revision rhinoplasty. In recent years, adjuvant therapies, including nasal fat grafting and cell component injection, are applied before revision rhinoplasty to soften the nasal envelope. Herein, autologous shuffling lipo-aspirated fat and manual mechanical stretch were combined as adjuvant therapy before revision rhinoplasty. A total of 24 patients with severe nasal contracture were included in this study. Of these, 8 received autologous shuffling lipo-aspirated fat and manual mechanical stretch before revision rhinoplasty (comprehensive therapy), 8 underwent mechanical stretch and revision rhinoplasty, and 8 patients underwent only revision rhinoplasty. The objective and subjective outcome assessment was processed in the follow-up period of 6 months. Nasal length, nasal tip projection, nasofrontal angle, and nasolabial angle were measured, and potential complications were assessed. All 24 patients underwent a successful revision rhinoplasty. In the comprehensive therapy group, no patient had postoperative wound infection and defect of the nasal column mucous. The comprehensive treatment group had the most significant improvement in nasal length and nasal tip projection, and the nasolabial angle was the closest to 90°, which indicated the most effective nasal revision and aesthetic contour. The adjuvant therapy combines autologous shuffling lipo-aspirated fat and manual mechanical stretch before revision rhinoplasty could effectively improve the surgical outcome and decrease the postoperative complications regarding severe nasal contractures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Impact of Traditional Chinese Medicine QingreHuoxue Treatment and the Combination of Methotrexate and Hydroxychloroquine on the Radiological Progression of Active Rheumatoid Arthritis: A 52-Week Follow-Up of a Randomized Controlled Clinical Study.

Traditional Chinese medicine (TCM) has been used successfully to treat rheumatoid arthritis (RA). QingreHuoxue treatment (QingreHuoxue decoction [QRHXD]/QingreHuoxue external preparation [QRHXEP]) is a Chinese medicine treatment for RA. To date, very few studies have compared the long-term effects of QRHXD with those of conventional disease-modifying antirheumatic drugs on RA disease activity and radiological progression. QRHXD delayed the radiological progression and showed long-term clinical efficacy of RA. In clinical experiments, the clinical evidence of delaying the radiological progression of RA patients was obtained. A portion of the patients who participated in the “Traditional Chinese Medicine QingreHuoxue Treatment vs. the Combination of Methotrexate and Hydroxychloroquine for Active Rheumatoid Arthritis” study were followed up for 52 weeks, and intention-to-treat (ITT) and compliance protocol (PP) analyses were used to collect and compare the clinical indicators and imaging data between baseline and week 52. Two radiologists who were blind to treatment scored the images independently. Of the 468 subjects, 141 completed the 52-week follow-up. There were no significant differences among the three groups: the traditional Chinese medicine comprehensive treatment group, the Western medicine treatment group, and the integrated traditional Chinese and Western medicine treatment group. There were no differences in the total Sharp score, joint space stenosis score, and joint erosion score at baseline or 52 weeks. In the comparison of the estimated annual radiographic progression (EARP) and the actual annual Sharp total score changes among the three groups, the actual changes were much lower than the EARP at baseline. The radiological progress in all three groups was well controlled. Results of the ITT and PP data sets showed that the disease activity score 28 level of the three groups at 52 weeks was significantly lower than that at baseline. During the 52-week treatment period, the clearance of heat and promotion of blood circulation controlled disease activity and delayed the radiological progress of active RA.

Efficacy of Buqi Huoxue Decoction Combined with Cardiac Rehabilitation Nursing after Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction and Its Influence on Prognosis.

Objective To investigate the efficacy of the application of Buqi Huoxue Decoction combined with cardiac rehabilitation nursing for patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and its influence on the prognosis. Methods 120 STEMI patients undergoing PCI were randomly divided into control group, cardiac care group, traditional Chinese medicine and western medicine group (TCM + WM group), and comprehensive treatment group. The control group was treated with a conventional antiplatelet therapy. On the basis of the control group, the cardiac care group was combined with cardiac care treatment. The TCM + WM group was combined with Buqi Huoxue Decoction, and the comprehensive treatment group was combined with cardiac rehabilitation care and Buqi Huoxue Decoction. The total clinical effective rate, readmission rate, and adverse reaction rate of the four groups were measured. Moreover, the myocardial injury markers (creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), and α-Hydroxybutyrate dehydrogenase (α-HBDH)), vascular endothelial function indexes (endothelin (ET-1) and vascular endothelial growth factor (VEGF)), cardiac function indexes (left ventricular ejection fraction (LVEF), left ventricle shortening rate (LFS), left ventricular end diastolic diameter (LVEDd), and left ventricular end systolic diameter (LVESd)), and QOL quality of life score (appetite, spirit, sleep, fatigue, and daily life) were measured. Results The total effective rate of comprehensive treatment group was obviously increased versus to the control group and cardiac care group. The CK-MB, cTnI, α-HBDH, ET-1, LVEDd, and LVESd levels and SAS and SDS scores in the four groups were decreased, and VEGF, LVEF, and FS levels and QOL quality of life scores were increased after treatment. Moreover, the comprehensive treatment group has more significant changes than the other three groups. The readmission rate in comprehensive treatment group was significantly lower than the other three groups, and the difference in the incidence of adverse reactions in the four groups was not statistically significant. Conclusion Buqi Huoxue Decoction combined with cardiac rehabilitation after PCI has a significant clinical effect on STEMI patients with PCI postoperative treatment, which can effectively reduce myocardial injury, improve the patient's cardiac function and vascular endothelial function, and improve the patient's quality of life, which can better improve the prognosis of patients.

Effect of Qingre Jiedu Huoxue Huayu Recipe on blood stasis and toxin syndrome in patients with non-ST segment elevation acute coronary syndrome, serum Lp-PLA2, TNF- α, and PIGF expression level.

The pathological basis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is severe coronary stenosis, unstable plaque erosion, and rupture, resulting in coronary blood flow reduction and myocardial ischemia, leading to acute thrombosis cardiovascular disease events. This subject intends to study the treatment of NSTE-ACS patients with blood stasis and toxin syndrome by Qingre Jiedu Huoxue Huayu Decoction, observe its clinical efficacy, and explore the effects of serum lipoprotein phospholipase A2 (Lp-PLA2) and tumor necrosis factor- α (TNF- α), the effect of placental growth factor (PIGF) expression. In this study, 100 patients with blood stasis and toxin syndrome of NSTE-ACS treated in the cardiovascular department of Enshi National Hospital from August 2020 to August 2021 were selected as the research object. They were randomly divided into traditional Chinese medicine comprehensive treatment groups and conventional western medicine control groups, with 50 cases. The conventional western medicine control group was treated with hydroclopidogrel tablets orally, and the comprehensive treatment group of traditional Chinese medicine combined with Qingre Jiedu Huoxue Huayu formula orally. The patients in both groups were treated for four weeks. The results showed that after treatment, the practical clinical rate of the comprehensive treatment group was significantly higher than that of the conventional western medicine control group. After treatment, the TCM syndrome score, angina pectoris attack duration, and angina pectoris attack frequency, myocardial zymogram index level, serum Lp-PLA2 and TNF of the two groups were measured- α. The levels of PIGF were significantly lower than those before treatment. The decline of the above indexes in the comprehensive treatment group of traditional Chinese medicine was significantly better than that in the control group of conventional Western Medicine (P<0.05). The incidence of MACE events in the TCM Comprehensive treatment group was significantly lower than that in the conventional western medicine control group (P <0.05).

Clinical analysis of 48 cases of malignant superior vena cava syndrome

BackgroundThe aim of our study was to observe and compare the curative effect of radiotherapy, chemotherapy, and combined radiotherapy and chemotherapy, as well as comprehensive treatment on superior vena cava syndrome (SVCS) caused by malignant etiology.MethodsA total of 48 patients with malignant SVCS admitted to our hospital from 2015 to 2020 were selected in this study. According to the different treatment methods, they were divided into radiotherapy group (group 1, 10 cases), chemotherapy group (group 2, 8 cases), combined radiotherapy and chemotherapy group (group 3, 22 cases), and comprehensive treatment group (group 4, 8 cases).ResultsThere were no significant differences in efficacy and side effects among the four groups (all P > 0.05). Group 4 (median survival time of 36 months) could provide longer survival time than groups 1, 2, and 3 (median survival time of 10 months, 13.5 months, and 12 months, respectively).ConclusionsFor patients with severe symptoms or good prognosis, comprehensive treatment could be selected to improve the quality of life and prolong the survival period; for patients with mild symptoms, radiotherapy, chemotherapy, or combined radiotherapy and chemotherapy could also reduce the symptoms of SVCS and treat tumor lesions.

Clinical study on swallowing function of brainstem stroke by tDCS

ObjectiveTo investigate the effect of transcranial direct current stimulation (tDCS) combined with conventional comprehensive rehabilitation on dysphagia after brainstem stroke.Materials and methodsForty brainstem stroke patients were randomly divided into tDCS group and conventional comprehensive treatment group, including 20 patients in each group. Both groups were given routine swallowing function training, and tDCS group added transcranial direct current stimulation (tDCS). The Dysphagia Outcome and Severity Scale (DOSS) and Functional Dysphagia Scale (FDS) were evaluated respectively before and after 8 weeks of continuous treatment with VFSS. The white blood cell (WBC), c-reactive protein, prealbumin (PAB), albumin (Alb), and hemoglobin (Hb) were also compared between the two groups before and after 8 weeks of continuous treatment.ResultsAfter 8 consecutive weeks of treatment, the score of DOSS scale and FDS scale in both groups was improved (P < 0.05), WBC and CRP were decreased (P < 0.05), and Alb and Hb were improved (P < 0.05), and PAB had no differences (P=0.474). The tDCS group was superior to conventional comprehensive group in improving the swallowing function and nutritional indexes (P < 0.05).ConclusionstDCS therapy combined with routine training can improve the swallowing function and nutritional status of patients, and reduce infection.

Changes and clinical significance of serum NSE and MBP levels in children with cerebral palsy at high altitude during comprehensive rehabilitation

Objective: To explore the changes of serum neuron-specific enolase (NSE) and myelin basic protein (MBP) in children with cerebral palsy at high altitude during comprehensive rehabilitation and their clinical significance. Methods: A clinical randomized controlled study design was used to select 144 children with cerebral palsy who were diagnosed and treated in the Rehabilitation Center of Xining Traditional Chinese Medicine Hospital of Qinghai Province from June 2018 to October 2019, including 83 males and 61 females, aged 3-5 years old. According to the order of admission, the random number table was used to divide into a conventional treatment group (n=72, 40 males and 32 females) and a comprehensive treatment group (n=72, 43 males and 29 females). The conventional treatment group was treated with conventional rehabilitation. The comprehensive treatment group was treated with monosialotetrahexose ganglioside sodium on the basis of conventional rehabilitation. In addition, 30 healthy children aged 3-5 years, 16 males and 14 females, were selected as the control group during the physical examination of the Pediatrics Department of Xining Hospital of Traditional Chinese Medicine, Qinghai Province. The serum levels of NSE and MBP in each group were detected, and the children's GMFM-88 scores were evaluated before and after treatment. The SPSS19.0 software was used for statistical analysis, the count data was tested by χ2. Results: The serum NSE and MBP levels of the control group were (5.96±0.80), (0.71±0.15) μg/L. Before treatment, the serum NSE and MBP levels of children with severe, moderate, and mild cerebral palsy were [(21.63±1.92), (3.63±0.49) μg/L], [(17.86±1.43) μg/L, (2.21±0.07) μg/L] and [(15.14±0.95), (1.76±0.30) μg/L], respectively. After treatment, the serum NSE and MBP levels of the conventional treatment group and the comprehensive treatment group were [(13.54±2.41), (2.07±0.85) μg/L] and [(12.09±2.37), (1.81±0.69) μg/L], respectively, and the GMFM-88 score was (116.75±27.41) points and (125.94±24.93) points. The levels of NSE and MBP in the serum of children with cerebral palsy were significantly higher than those of normal children in the control group, and their levels increased with the degree of disease, and the corresponding gross motor function scores were lower. After treatment, the GMFM-88 scale assessment scores of the two groups of children were significantly improved (t values were 310.97 and 70.86, P values were both<0.05), and serum NSE and MBP levels decreased to varying degrees compared with before treatment. The decline in the comprehensive treatment group was greater than that in the conventional treatment group. Conclusions: Serum NSE and MBP levels in children with cerebral palsy at high altitude are significantly higher than those in healthy children, and their levels are closely related to the degree of impairment and GMFM-88 scores in children with cerebral palsy. Dynamic monitoring of changes in NSE and MBP levels may be responsible for the condition and treatment effects of children with cerebral palsy judgments based.

Study on the effect of rehabilitation therapy based on deep learning on functional recovery of stroke patients with hemiplegia

Objective: Based on deep learning, to explore the clinical effect of early rehabilitation intervention management model on the recovery of neurological function in patients with acute stroke. Methods: A total of 86 inpatients in our department from June 2019 to August 2020 were selected. According to the ward distribution, the hospital was randomly divided into routine drug treatment group (control group, 44 cases) and another ward was divided into early comprehensive rehabilitation treatment group (treatment group, 42 cases). The treatment group received regular rehabilitation training in addition to clinical medication, while the control group received clinical medication and self-exercise without guidance. They were evaluated 24 hours before treatment and 7-10 weeks after treatment. The motor function was evaluated by Furl—Meyer motor function integral method (FMA), and the daily living ability was scored by Barthel index. Results: There was no significant difference in Barthel index and FMA score between the treatment group and the control group before treatment. After treatment, the two indexes in the control group improved to a certain extent, but compared with the treatment group, the improvement degree was far less than that in the treatment group, and the difference was statistically significant (P < 0.01). The effective rate and total effective rate in the treatment group were significantly higher than those in the control group, with statistical difference between the two groups (P<0.05). Conclusion: Early rehabilitation intervention management model can effectively improve the neurological function of patients with acute stroke and improve the clinical efficacy, which is worthy of further promotion and use in clinical practice.

Prognostic and survival analyses of early-stage diffuse large B-cell lymphoma of Waldeyer′s ring

Objective To analyze the clinical efficacy and prognostic factors of patients with early-stage diffuse large B-cell lymphoma of Waldeyer′s ring (WR-DLBCL) treated with CHOP-based chemotherapy. Methods A total of 137 patients diagnosed with WR-DLBCL admitted to our hospitalfrom 2006 to 2018 were enrolled, including 22 patients with stage Ⅰ and 115 patients with stage Ⅱ WR-DLBCL. All patients received CHOP-based chemotherapy, of whom 62 receiving rituximab and 87 receiving involved-field radiotherapy. The overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRRFS) were calculated by Kaplan-Meier method. Log-rank test, was conducted for univariate analysis and Cox’s regression model was performed for multivariate analysis. Results The 5-year OS, PFS, and LRFFS in the whole group were 78.6%, 69.5% and 83.2%, and 87.5%, 80.2%, 90.9% in the comprehensive treatment group, and 64.2%, 53.6% 72.9% in the chemotherapy group, respectively. Univariate analysis showed that lactate dehydrogenase (LDH), international prognostic index score, large mass, rituximab, chemotherapy cycle and comprehensive treatment were the prognostic factors of OS and PFS. In addition, LDH, large mass and comprehensive treatment were the prognostic factors associated with LRFFS. Multivariate analysis demonstrated that LDH, comprehensive treatment mode and rituximab were the prognostic factors of OS. LDH and comprehensive treatment mode were the prognostic factors associated with PFS. LDH was a prognostic factor of LRFFS. Conclusion Patients with early-stage WR-BLBCL obtain excellent clinical prognosis. In the era of rituximab treatment, chemotherapy combined with radiotherapy remains an efficacious treatment of early-stage WR-BLBCL. Key words: Diffuse large B-cell lymphoma of Waldeyer′s ring/targeted therapy; Diffuse large B-cell lymphoma of Waldeyer′s ring/radiotherapy; Diffuse large B-cell lymphoma of Waldeyer′s ring/chemotherapy; Prognosis

Corticosteroid improves liver function but does not curb the clinical progression of hepatitis B virus-related acute-on-chronic pre-liver failure

ABSTRACTBackground: Hepatitis B virus-related acute-on-chronic pre liver failure (HBV pre-ACLF) has the potential for progression to HBV ACLF. Whether corticosteroid is useful for HBV pre-ACLF remains heterogeneous. This study aimed to evaluate the efficacy of short-term (5 days) and low-dose dexamethasone (5mg/d) toward HBV pre-ACLF.Design and methods: One hundred twenty-one patients with HBV pre-ACLF were randomly divided into two groups: medical comprehensive treatment (MCT) group and corticosteroid treatment (CT) group. Laboratory measurements at admission and 7 days post-admission were compared between the two groups, respectively. Hospitalization periods and clinical progression were also monitored and compared between the two groups.Results: Higher than normal levels of ALT, AST, TBIL, DBIL, TBA and GLO were observed at 7 days after admission in patients in the MCT group than in CT group (p < 0.001).Patients in the CT group had shorter inpatient days than the MCT group (p = 0.002).During hospitalization and treatment, the incidence of HBV ACLF was not substantially different between the two groups (14.8% vs. 8.3%, p = 0.271).Conclusions: Corticosteroid is effective at improving the liver function and decreasing hospitalization periods of patients with HBV pre-ACLF but does not prevent HBV pre-ACLF from progressing to HBVACLF.

Comprehensive treatment in stroke unit can improve the cognitive function and the life quality of stroke survivors with vascular cognitive impairment as well as the mental state of their caregivers

Objective To study the effect of comprehensive treatment in stroke unit on the cognition and life quality of patients with vascular cognitive impairment (VCI) and also its effects on the mental state of their caregivers. Methods Ninety-three persons with VCI were randomly divided into a control group (n=44) and a comprehensive treatment group (n=49) after being admitted into the stroke unit. Both groups took routine basic drugs (such as anti-platelet drugs, lipid lowering drugs, anti-hypertension drugs, huperzine-A tablets and Nicergoline tablets). The treatment group was additionally provided with limb movement rehabilitation training, social practice, cognitive training and health education. During the treatment, the treatment group′s caregivers were also given health education about VCI and stroke, systematic rehabilitation knowledge and skills training and appropriate anti-depressant and anxiety medication if need. Before the treatment, as well as 3 and 6 months after the treatment, the patients of both groups were evaluated using the mini-mental state examination (MMSE), the Montreal cognitive assessment (MoCA), their ability in the activities of daily living (ADL) was rated and Spitzer quality of life (QLI) values were assigned. The caregivers were evaluated using the Hamilton depression scale (HAMD) and the Hamilton anxiety scale (HAMA). Results After 3 and 6 months of treatment, the average MMSE, MoCA, ADL and QLI scores of the treatment group had improved significantly and were then significantly better than those of the control group at the same time points. The average HAMD score of the treatment group was also significantly better. Conclusion Comprehensive stroke unit therapy can improve the cognition and life quality of patients with vascular cognitive impairment. It can also improve the mental state of their caregivers. Key words: Stroke; Cognition; Quality of life; Caregivers; Psychological status

Clinical observation on plum-blossom needle combined with rehabilitation training for hand spasm after stroke

To observe the effect difference between plum-blossom needle combined with rehabilitation training and conventional rehabilitation training for hand spasm after stroke. A total of 61 patients were randomly divided into a comprehensive treatment group (30 cases) and a rehabilitation training group (31 cases). In the rehabilitation training group, Bobath occupational therapy, OT training, and hand function training were adopted, once every day; on the basis of treatment in the rehabilitation group, plum-blossom needle was applied at the lung meridian of hand-taiyin, heart meridian of hand-shaoyin, pericardium meridian of hand-jueyin in the comprehensive treatment group. The treatment was given once every two days, three weeks as one course in the two gnoups. After 3 courses of treatment, clinical efficacy evaluation was performed, and the modified Ashworth scale and Fugl-Meyer (FMA) motor function scores were assessed before and after treatment. After treatment, the grade for Ashworth scale and FMA scores in the comprehensive treatment group and the rehabilitation trainning group were better than those before treatment (all P<0.05), and the improvements in hand spasm and hand fuction in the comprehensive treatment group were superior apparently to those in the rehabilitation trainning group (both P<0.05) The total effective rate of hand function was 93.3% (28/30) in the comprehensive treatment group, which was better than 74.2% (23/31) in the rehabilitation training group (P<0.05). Plum-blossom needle combined with rehabilitation training are more effective than simple rehabilitation training for hand spasm after stroke.

Correlation analysis on clinical effects of acupuncture for elderly patients with sensorineural deafness and ear distending sensation

To investigate the relationship between clinical effects of acupuncture for elderly patients with sensorineural deafness and ear distending sensation. A total of 120 elderly patients with sensorineural deafness were randomly divided into a comprehensive treatment group, an acupuncture group and a Western medicine group, with 40 cases in each group. The acupuncture group received acupuncture treatment, the Western medicine group received oral mecobalamin tablets and the comprehensive treatment group received acupuncture plus acupoint injection and auricular acupoint sticking. The values of pure tone hearing threshold test of the three groups were observed before and after treatment, and the relationship between clinical effects and ear distending sensation was compared. The total effective rate of the comprehensive treatment group was 82.5% versus 67.0% in the acupuncture group and 62.5% in the Western medicine group. The inter-group comparisons showed statistically significant differences in the comprehensive treatment group versus the Western medicine group (P 0.05). The comprehensive therapy is one of the effective methods to treat elderly patients with sensorineural deafness. In the three groups of elderly patients with sensorineural deafness, the relief of ear distending sensation and the hearing loss were basically simultaneous, and the hearing recovery in the patients with ear distending sensation may be slightly better than that in those without ear distending sensation. Nevertheless, further research is needed.

Survival after surgical or radiotherapeutic treatment for high-risk localized prostate cancer: A National Cancer Database analysis with comprehensive treatment group imbalances adjustments.

55 Background: There are no randomized trials to guide a high-risk localized prostate cancer patient’s treatment decision between radiotherapeutic and surgical options. Comparative studies have been limited by their ability to match patients based on pre-treatment prognostic variables and to adjust for the cancer–related, medical and socioeconomic differences between patients who choose radiotherapeutic or surgical approaches. Methods: We analyzed the outcome of all patients in the National Cancer Database with high-risk clinically localized prostate cancer with complete prognostic data who were treated with either radical prostatectomy (RP), external beam radiotherapy (EBRT) combined with androgen deprivation (AD) or EBRT+brachytherapy (brachy)±AD. Inverse probability of treatment weighting (IPTW) was used to adjust for covariate imbalance between treatment groups. Time-dependent Cox proportional hazards (TDCPH) model was then used to evaluate differences between treatment groups. Because of imbalances in the frequency of pathologic lymph node sampling between the treatment groups, a predictive model of pathologic nodal (pLN) status was built using PSA, Gleason score and clinical T stage and predicted pLN status was used to repeat the IPTW and TDCPH model. Results: 42,765 patients were analyzed. There was no statistically significant difference in survival between RP and EBRT+brachy±AD (HR 1.17 (0.88, 1.55)). However, EBRT+AD was associated with higher mortality than RP (HR 1.53 (1.22, 1.92)). Adjustment for predicted pLN status did not change the results. Subset analysis of EBRT+AD patients who received ≥7920 cGy narrowed the difference but remained significant (HR 1.32 (1.02, 1.66)). Conclusions: After comprehensively adjusting for imbalances in prostate cancer prognostic factors, other medical conditions and socioeconomic factors, this analysis showed no difference in survival between patients treated with RP vs. EBRT+brachy±AD. EBRT+AD was associated with lower survival. Randomized trials comparing these three methods of treatment are urgently needed.

Efficacy and safety of Kuhuang injection in treating viral hepatitis： systematic review and Meta-analysis of randomized controlled trials

To systematically evaluate the effectiveness and safety of Kuhuang injection in treating viral hepatitis. Eight electronic databases and clinic trials were searched to collect randomized controlled trials for the effect of Kuhuang injection in the treatment of viral hepatitis. According to the Cochrane Handbook 5.1, two independent reviewers screened out the literatures, extracted data and assessed the quality of thestudies included. RevMan5.3 software was used for the data analysis. A total of 32 articles were included, involving 3 188 patients, including male 1 951 cases (61.2%), female 859 cases (26.9%), and 378 cases of unknown sex (11.9%). All the clinical studies showed a low quality. Due to the complication of diseases and difficulty in intervention measures, most trails were classified by the condition of diseases, and then a descriptive analysis was made. The results showed that the test group was better than the control group in total efficiency of treating severe icteric viral hepatitis, and the test group was advantageous over the control group in jaundice removal and liver function recovery rate in treating icteric hepatitis. In the Meta-analysis on the RCTs for icteric viral hepatitis, the total efficiency of Kuhuang injection + comprehensive treatment group was higher than that of the comprehensive treatment group （RR=1.35, 95%CI=[1.10,1.66], P=0.61）. In addition, when Kuhuang injection was dripped too fast, patients had such adverse reactionsas dizziness, palpitation, nausea, vomiting and skin rash, which could be relieved at a lower dripping speed.Based on the existing evidences, Kuhuang injection had a certain effect in treating viral hepatitis. Most clinic trails did not include viral hepatitis etiology, clinical classification and diversified intervention measures, which resulted in a high clinical heterogeneity and poor comparability between trails. Besides, most trials had a low methodological quality, which affected the authenticity of the results. Therefore, more high-quality, multi-center, large-sample, randomized double-blind controlled trialsarerequired to prove the evidences.

Comprehensive rehabilitation in the management of traumatic elbow fracture with elbow dysfunction

Objective To explore the application of comprehensive rehabilitation therapy in elbow joint dysfunction resulted from traumatic elbow fracture. Methods Sixty-eight patients with elbow dysfunction after fractures were treated in our hospital between June 2014 and June 2015. The patients were randomly divided into the comprehensive treatment group and control group with 34 patients each. Patients in the comprehensive treatment group underwent the comprehensive rehabilitation therapy (traditional Chinese herbal fumigation+fine-tuning static drawing limp+arthrosis mobilization+active training). Patients in the control group were treated with arthrosis mobilization only. Visual analogue scale (VAS) pain score and Mayo elbow performance score were assessed before and 2, 6 and 12 weeks after the treatment, respectively. Results After 2, 6 and 12 weeks of treatment, VAS pain score and Mayo elbow performance score were improved in patients of both groups compared with pre-treatment. The differences were statistically significant (P<0.05). The scores of the comprehensive treatment group were all significantly higher than scores of the control group (P<0.05). Conclusion Comprehensive rehabilitation therapy can not only improve the function of the elbow, but also greatly improve the efficacy of rehabilitation, which is worth to be popularized and applied clinically. Key words: Elbow joint; Fractures; Dysfunction; Comprehensive rehabilitation

Clinical effects of keen osteoarthritis and meniscus injury by comprehensive treatment

Objective To investigate the projects and effects of the comprehensive and conservative treatment of patients with keen osteoarthritis and meniscus injury. Methods 120 patients with keen osteoarthritis and meniscus injury were randomly divided into the control group A(n=40),B(n=40)and comprehensive treatment group C(n=40).Patients in group A were treated with ozone and glass sodium injection;Patients in group B were treated with ozone,glass sodium and Triamcinolone Acetonide injection;Patients in group C were treated with ozone,glass sodium and Triamcinolone Acetonide injection,superlaser local irradiation,glucosamine tablet oral,Lornoxicam intravenous injection.The effects of the treatment according to keen joints function scores were compared after two weeks and six months.Patients in group C were randomly divided into group C1(n=20)and group C2(n=20)after one year,patients in group C1 with the same treatment as patients in group A and oral glucosamine tablet for one course of treatment,patients in group C2 without any further treatment.The follow up was completed for two years. Results The excellent and good rate in group C was better than that of group B and group C after two weeks(70.0%,22.5%,42.5%,χ2=18.152,6.146,P<0.01 or P<0.05).After six month,the excellent and good rate in group C was better than that of group A and group B(87.5%,42.5%,60.0%,χ2=17.802,7.813,all P<0.01).There was no significant difference between group C1 and group C2 after one years(t 1=2.014,P<0.01).There was significant difference between group C1 and group C2 after two years(t2=16.152,P<0.01). Conclusion The effects of comprehensive conservative treatment are better than simple keen joint injection in patients with keen osteoarthritis and meniscus injury. The function of keen joint with maintenance care treatment is better than without maintenance care.Comprehensive conservative and maintenance care treatment is a good clinical treatment project. Key words: Osteoarthritis,Knee; Menisci,Tibial; Therapeutics