@@

Objective To evaluate the clinical effect of Shuxuetong plus external application of deproteinised calf blood serum injection on diabetic ulcer foot.Methods 60 patients with diabetic foot ulcer were enrolled:30 cases (treatment group)were randomly assigned to receive deproteinised calf blood serum injection(external use)plus Shuxuetong(iv gtt),and the other 30 cases (control group)received routine western medicine therapy.One course of treatment lasted one month.In addition,both two groups received insulin to control blood sugar and antibiotics to control infection,with foot ulcer treated with debridement,drainage,and removal of necrotic tissue etc.Results Com-pared with the control group,the effective rate was higher in the treatment group(86.7% vs.60.0%,χ2 =5.455,P =0.020).The occurrence time of granulation tissue[(6.60 ±1.14)d vs.(10.80 ±2.17)d,t =-3.834,P =0.008] and wound healing time[(23.62 ±6.14)d vs.(35.65 ±4.45)d,t =-4.405,P =0.002]were shorter in the treat-ment group.The wound area in the two groups reduced after treatment,and the wound area in the treatment group reduced significantly[(3.48 ±1.16)cm2 vs.(8.60 ±2.51)cm2 ,t =-4.143,P =0.007].Conclusion As com-pared with the routine therapy with western medicine,the combination therapy of deproteinised calf blood serum injec-tion plus Shuxuetong has better efficacy for diabetic ulcer foot.

Objective To assess the clinical effect of safflower yellow combined with kallidinogenase on ear-ly diabetic nephropathy.Methods 80 early diabetic nephropathy patients were all given diet control, appropriate exerciseand positive controlled blood sugar,blood fat,blood pressure.They were randomly divided into two groups,the control group was intramuscularly given kallidinogenase 40U dissolved in sodium chloride,once daily.Based on this, the treatment group added safflower yellow 100mg into 5%glucose injection 250mL and 3 unit insulin by intravenous drip.The period of treatment was three weeks.24h urinary micro-albumin(U-ALB) and urinary albumin excretion rate( UAER) before and after treatment between the two groups were surveyed.Results Before treatment,24 h U-ALB and UAER of the control group were (100.44 ±65.72) mg/L,(117.31 ±68.32)μg/min,which of the treatment group were (123.57 ±63.28) mg/L,(138.57 ±50.82)μg/min.There were no significant differences between the two groups(t=1.098,1.056,all P>0.05).After treatment,24h U -ALB and UAER of the control group were (79.39 ±65.33)mg/L,(92.68 ±67.95)μg/min,which in the treatment group were (71.87 ±60.03)mg/L,(62.52 ± 38.64)μg/min.Statistical differences of 24h U-ALB and UAER were observed in the two groups compared with before treatment(the control group:t=5.903,6.069,the treatment group:t=6.779,12.612,all P<0.05).After treatment, there was no significant difference in 24h U-ALB between the two groups(t=-0.386,P>0.05),while UAER in the treatment group was lower than the control group(t=-2.029,P<0.05).Conclusion Safflower yellow com-bined with kallidinogenase can reduce UAER in early diabetic nephropathy,and what's more,can put off its progress.

Objective To explore the effect of Rhodiola kirilowii Regel combined with calcium dobesilate in the treatment of early diabetic nephropathy.Methods 80 patients with early diabetic nephropathy were selected,and they were divided into treatment group and control group according to the digital table,40 cases in each group.The two groups were given diet control and appropriate exercise and positive controlled blood sugar,blood fat,blood pressure.The control group was given calcium dobesilate,based on this,the treatment group was given Rhodiola kirilowii Regel 10mL into 5％ glucose injection 250mL and 3 unit insulin to intravenous drip.The period of treatment was fifteen days.The UAER,Scr and BUN were compared between two groups before treatment and fifteen days after treatment.Results Before treatment,the Scr,BUN and UAER in the control group were (88.00 ± 18.19) μmol/L,(5.98 ± 1.92) mmol/L,(123.31 ± 60.01) μg/min respectively,which in the treatment group were (85.80 ± 18.31) μmol/L,(5.96 ± 1.94) mmol/L,(140.21 ± 62.92) μg/min respectively,there were no statistically significant differences between the two groups(t =-1.191,-0.016,0.432,all P ＞0.05).After treatment,the Scr,BUN and UAER in the control group were (84.61 ± 11.71) μmol/L,(6.30 ± 1.37) mmol/L,(97.81 ± 49.16) μg/min respectively,which in the treatment group were (75.60 ± 11.44) μmol/L,(5.25 ± 1.24) mmol/L,(39.81 ± 23.43) μg/min.There were no statistically significant differences in Scr and BUN of the two groups compared with before treatment (the control group:t =0.767,-0.657;the treatment group:t =1.947,1.219,all P ＞ 0.05).There was statistically significant difference in UAER of the two groups compared with before treatnent (t =2.850,5.402;P =0.046,0.006),but UAER of the treatment group after treatment decreased significantly.After treatment,there were no statistically significant differences in Scr and BUN between the two groups (t =-1.229,-1.236,all P ＞ 0.05),while there was statistically significant difference in UAER between the two groups (t =-2.394,P =0.044).The effective rate in the treatment group was 87.5 ％,which was higher than 57.5 ％ of the control group (x2 =9.028,P ＜ 0.05).Conclusion Rhodiola kirilowii Regel combined with calcium dobesilate can ameliorate protenuria and improve renal function of the patients with early diabetic nephropathy.

Objective To retrospectively analyze the treatment results and side effects of postoperative chemoradiotherapy and postoperative radiotherapy of thoracic esophageal squamous cell carcinoma (EPC) with positive lymph nodes.Methods Three hundred and four patients of thoracic EPC were initially treated with three-field lymphadenectomy, with pathological positive lymph nodes and without distant metastases;and randomly divided into two groups:140 patients of the simple postoperative radiotherapy (RT) and 164 patients of postoperative chemoradiotherapy (CRT).The median total dose was 50 Gy.The regimen of concurrent chemotherapy included cisplatin and taxol, and the intermission was 21 days;the median cycles were 2.35.Results The 3-year overall survival rates were 65.7% of CRT and 52.8% of RT (χ2=6.90,P=0.009), and The 3-year disease-free survival rates were 62.5% of CRT and 52.8% of RT (χ2=4.75,P=0.029).The incidences of the supraclavicular lymph-node metastases were 1.8% and 7.1%(χ2=5.21,P=0.022), respectively;and the incidences of distant metastases were 18.3% and 27.9%(χ2=3.94,P=0.047), respectively;and the incidences of overall metastases and recurrences were 27.4% and 39.3%(χ2=4.80,P=0.028), respectively.Early side effects included granulopenia (96.3% and 32.1%,χ2=140.31,P=0.000), radiation-induced esophagitis (37.2% and 26.4%,χ2=4.01,P=0.045),and gastrointestinal toxicity (23.2% and 5.0%,χ2=19.77,P=0.000).Late side effects were 6.1% and 5.0%(χ2=0.17,P=0.678), respectively.Conclusions Postoperative chemoradiotherapy of thoracic EPC with positive lymph nodes can improve the overall survival and disease-free survival, decrease the incidence of the supraclavicular metastases, the distant metastases, the total metastases and recurrences.More severe early side effects were observed in chemoradiotherapy than in the radiotherapy group,but well tolerated.

Objective To analyze the relationship between the number as well as distributions of positive lymph nodes, and the clinical outcomes of postoperative radiotherapy for thoracic esophageal squamous cell carcinoma (TESCC) , And to evaluate the efficacy of postoperative radiotherapy . Methods From January 1993 to March 2007,945 patients with TESCC treated with three-field lymphadenectomy were involved in this study. All patients were with lymphoid metastasis but without distant metastasis. Among them, 590 patients received surgery alone and the other 355 received surgery plus postoperative radiotherapy. The radiotherapy were begun in the third or fourth week after operation and the median total radiation dose was 50 Gy in 25 fractions of 2 Gy, 5 fractions per week. Results The follow-up rate was 94.5%. 189 patients finished minimal follow-up of five years. The 5-year survival rates in the surgery alone group and in the postoperative radiotherapy group were 29.6% and 38.0%, respectively (χ~2 = 10.44 ,P = 0.001). In stratification analysis, compared with the surgery alone, postoperative radiotherapy could increase the 5-year survival rate of the patients with 3 to 5 (30.5% : 23.1%, χ~2 = 4.11, P = 0.043) or > 5 positive nodes (16.7% : 8.9%, χ~2= 6.87, P= 0.009) , or metastastatic node in the region of supraclavicular or upper mediastinum (45.5% : 34.9%, χ~2= 5.37, P = 0.020). In patients with positive nodes number less than 3, or with medium mediastinum or lower mediastinum lymph nodes metastasis, postoperative radiotherapy could not increase the 5-year survival rates (50.7% : 41.2%, χ~2 = 3.30, P = 0.069 ; 32.0% : 27.7% , χ~2= 2.22 , P = 0. 137) , Though could decrease lymph nodes metastasis in supraclavicular and medium-upper mediastinum (15 : 76, χ~2 = 18.10, P = 0.000; 18 : 97, χ~2= 26.81, P = 0.000). Conclusions In TESCC patients with positive lymph nodes number ≥3 or nodes in the region of supraclavicular and upper mediastinum, postoperative radiotherapy can improve the survival after three field lymphadenectomy. And the rate of metastastatic lymph nodes in the supraclavicular region or upper-medium mediastinum can also be decreased.

Objective To evaluate the value of postoperative prophylactic radiotherapy for N0 e-sophageal squamous carcinoma. Methods From January 1993 to December 2006,859 patients with patho-logically staged N0 and M0 esophageal squamous cell carcinoma were included in this study. Among them, 760 received surgery alone, and 99 received surgery followed by postoperative radiotherapy. Radiotherapy started within 3 to 4 weeks after surgery. The median total dose was 50 Gy(2 Gy/F,5 F/w). Results In surgery alone group and postoperative radiotherapy group,the 5-yeur overall survival rotes were 72.2% vs 77.4% (X2 =0. 13,P >0.05) for all patients,34.6% vs67.1% (X2 =7.72,P <0.05) forpT4 disease,and 70.2% vs 81.3% (X2 =4.01 ,P <0.05) for tumor length >5 cm. Postoperative radiotherapy could lower the recurrence rate for pT4 patients. Conclusions For patients with NO esophageal squamous carcinoma, postoperative radiotherapy can significantly improve the survival for pT4 and tumor length > 5 cm,and also re-duce the recurrence for pT4 patients.

Objective:To explore the anti-inflammatory therapeutic effect and possible immunoregulatory mechanism of Buyang Huanwu Decoction (BYHWD) on the development of experimental autoimmune encephalomyelitis (EAE). Methods:Female C57BL/6 mice were immunized subcutaneously with myelin oligodendrocyte glycoprotein peptides ( MOG35-55 ) ,and randomly divided into saline group,BYHWD group,with 13 mice in each group. At the 3th day,25 ml/kg of saline was orally given to each mouse of saline group,50 g/kg ig of crude BYHWD was orally given to each mouse in BYHWD group for 25 days. Clinical score and body mass were recorded every day. Inflammatory cell infiltrations of spinal cord were observed by HE staining Myelin staining observes the demyelination situa-tion. And the expression of ROCKⅡ in spleen was detected by immunofluorescence staining. The subtypes of CD4+ T cells were analyzed by flow cytometry. Western blot was used to detect the expression of TLR4,Myd88,NF-κB,COX-2,ROCKⅡ in spinal cord and ROCKⅡ in brain. Results: The neurologicalscore significantly decreased in EAE mouse of BYHWD group compared with the saline group (P<0. 001) . BYHWD inhibited the inflammatory cell infiltration and demyelination in the nervous centralis(P<0. 05). The treatment of BYHWD effectively reduced the increased the proportion of CD25+(P<0. 05),IL-10+(P<0. 05),TGF-β+(P<0. 01), IFN-γ+( P<0. 05 ) CD4+T cells , and inhibited the expression of peripheral and central ROCKⅡ( P<0. 05 ) ;BYHWD reduced the expression of TLR4,MyD88,NF-κB,COX-2 in spinal cord (P<0. 05). Conclusion:BYHWD can exert anti-inflammatory and immune regulation effect by the inhibition of ROCKⅡ/TLR4/ NF-κB signaling pathway and regulation of the proportion of peripheral T cell sub-sets.

AIM:To evaluate the effect of lipoic acid ( LA) on LPS-induced Parkinson disease ( PD) model of mice.METHODS:Female C57BL/6 mice of 10-month-old were randomly divided into saline control group , PD group and LA group.The PD mouse model was induced by intranasal instillation of LPS .Assays of tyrosine hydroxylase , microglia and nuclear factor kappa B ( NF-κB) were performed by the methods of immunohistochemistry and Western blotting .RE-SULTS:Intranasal LPS instillation exhibited basic characteristics of PD model .However, LA administration significantly improved motor dysfunction , protected dopaminergic neurons from damage , and inhibited NF-κB activation in inflammatory microglia in the substantia nigra area of the brain .CONCLUSION:LA may exert a profound neuroprotective effect by an-ti-neuroinflammatory reaction to arrest the progression of PD .

Objective To evaluate the clinical effect of venenum bufonis combined with antibiotics in the treatment of bacterial liver abscess .Methods 60 patients with bacterial liver abscess were enrolled ,and all patients took percutaneous transhepatic puncture guided by ultrasound .They were randomly divided into two groups according to the digital table ,30 cases in each group .The control group received antibiotics treatment ,and the treatment group received venenum bufonis plus antibiotics intravenous drip ,once daily ,one course of treatment lasted seven days .The body temperature , blood routine , procalcitonin and other project changes of the two groups were detected .Results Compared with the control group,the effective rate of the treatment group was higher (96.7％ vs.80.0％,χ2 =4.043,P=0.044).In the treatment group,the time of body temperature returning to normal [(7.00 ±1.67)d vs. (9.00 ±1.41)d],leukocyte recovery time [(7.83 ±2.32) d vs.(9.82 ±1.94) d],procalcitonin recovery time [(7.00 ±1.67)d vs.(9.00 ±1.41)d],symptom disappearance time [(5.17 ±1.72)d vs.(7.50 ±1.87)d],disap-pearance time of abscess[(12.00 ±3.41)d vs.(16.00 ±2.37)d]were shorter than those in the control group(t=-2.601,-2.890,-2.236,-2.248,-2.362,P=0.026,0.016,0.049,0.044,0.041).Conclusion Venenum bufonis combined with antibiotics can significantly increase the curative rate and accelerate infection control , there-fore,it is worthy of popularizing in clinical practice .