OBJECTIVE To observe the clinical efficacy of modified Chaihu Guizhi Decoction in treating stable angina pectoris with anxiety/depression in patients with coronary heart disease of qi stagnation and blood stasis type.METHODS 60 patients with stable angina pectoris and anxiety/depression caused by qi stagnation and blood stasis type of coronary heart disease were included in the study.They were randomly divided into a control group(n=30)and a treatment group(n=30).Both groups of patients received health education,psychological counseling,and routine treatment for coronary heart disease angina pectoris.The control group received droperidol melitracin tablets in addition to basic treatment,while the treatment group received modified Chaihu Guizhi Decoction in ad-dition to basic treatment for 4 weeks.The efficacy of traditional Chinese medicine(TCM)syndrome,total score of traditional Chinese medicine syndrome,angina symptom score,electrocardiogram treadmill exercise test,nitroglycerin withdrawal rate,self-rating anxiety scale(SAS),self-rating depression scale(SDS),and Seattle angina questionnaire(SAQ)scores between the two groups of patients were compared before and after treatment.At the same time,peripheral blood lipids and IL-6 levels were measured.RESULTS Af-ter treatment,the TCM syndrome score,angina symptom score,SAS,SDS score of both groups of patients decreased(P<0.01),and the scores of various dimensions of SAQ increased(P<0.01).The occurrence time of ST segment depression of 1mm in treadmill exer-cise test was prolonged,the occurrence time of angina was prolonged,and the recovery time of ST segment was shortened(P<0.01),and TC,TG,LDL-C,IL-6 were significantly reduced(P<0.05,P<0.01).Moreover,the treatment group was superior to the con-trol group in improving TCM syndrome scores,angina symptom scores,SAS,SDS scores,PL and TS scores in SAQ,apparent effective rate of TCM syndrome,nitroglycerin cessation rate,blood lipids(TC,LDL-C),and serum IL-6(P<0.05,P<0.01).CONCLU-SION Modified Chaihu Guizhi Decoction can significantly improve the clinical symptoms,anxiety and depression status of patients with stable angina pectoris and anxiety/depression of qi stagnation and blood stasis type of coronary heart disease,improve quality of life,reduce blood lipids and IL-6 levels.

Objective To explore the mechanism of'homotherapy for heteropathy'Zhigancao Decoction in the treatment of coronary heart disease arrhythmia and pulmonary fibrosis by network pharmacology and molecular docking technology.Methods All the active components of Zhigancao Decoction were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and Herbal Compendium(HERB).The SwissTargetPrediction database was used to predict the targets.Cytoscape software was used to construct the drugs-targets network diagram and network topology analysis was performed to obtain the core drug targets.The disease targets of coronary heart disease,arrhythmia and pulmonary fibrosis were obtained in GeneCards and OMIM databases,and the intersection targets of Chinese medicine and disease were obtained by Venny software.The intersection targets were imported into the STRING online database to construct a protein-protein interaction network,and the data were imported into Cytoscape software for visualization and screening of core targets.Gene ontology(GO)function enrichment analysis and kyto encyclo-pedia of genes and genomes(KEGG)pathway enrichment analysis were performed on the intersection targets using the Metascape database.Molecular docking verification and heat map visualization were performed on the core intersection target and the core drug target through the CB-DOCK2 online platform.Results A total of 137 active components of Zhigancao Decoction were screened out,and 848 corresponding drug targets were obtained by removing repeated values.A total of 9 962 targets of coronary heart disease,5 735 targets of arrhythmia and 7 722 targets of pulmonary fibrosis were obtained.A total of 362 drug-disease intersection targets were obtained by Venny platform processing.The potential core targets with higher degree values were GAPDH,IL-6,ALB,STAT3,TNF,MMP-9 and so on by network topology analysis.GO functional enrichment analysis showed that the main biological processes(BP)involved in Zhigancao Decoction'homotherapy for heteropathy'were the response to hormones,the positive regulation of circulatory system process,phosphorus metabolism process,the response to exogenous stimulation,and the response to organic matter,the main cellular components(CC)include lipid rafts,receptor complexes,cytoplasmic perinuclear regions,dendrites,membrane sides,etc.,the main molecular functions(MF)include protein kinase activity,kinase binding,protein homopolymerization activity,nuclear receptor activity,heme binding,etc..KEGG pathway enrichment analysis showed that the main signaling pathways involved in Zhigancao Decoction'homotherapy for heteropathy'were lipid and atherosclerosis,calcium signaling pathway,cAMP signaling pathway,insulin resistance,cGMP-PKG signaling pathway,JAK-STAT signaling pathway,NF-κB signaling pathway,etc..The results of molecular docking suggested that there was a good binding activity between the main active component targets of Zhigancao Decoction and the core targets of'homotherapy for heteropathy'.Conclusion Zhigancao Decoction mainly regulates JAK-STAT,NF-κB,cAMP and other signaling pathways,acts on IL-6,STAT3,TNF,MMP-9 and other gene targets,and exerts the effect of'homotherapy for heteropathy'on coronary heart disease arrhythmia and pulmonary fibrosis.

OBJECTIVETo determine the optimal surgical modality for T3 glottic carcinoma.

METHODSClinical data of 57 cases of T3 glottic carcinoma were retrospectively reviewed. Their clinical characteristics, surgical procedures and prognosis were analyzed. At different ages and by surgical procedures performed, the 3-year disease-free survival rate of the patients were analyzed.

RESULTSAll cases underwent surgical procedures including total laryngectomy, near total laryngectomy and partial laryngectomy, and the 3-year disease-free survival rate was 63.2% (36/57). The 3-year disease-free survival rate of patients who received total laryngectomy was 66.7% (16/24), near total laryngectomy 50.0% (4/8), and partial laryngectomy 64.0% (16/25, P = 0.694). The 3-year survival rate of the cases ≥ 70.0 years old was 70.0% (7/10), and that of < 70 years old was 61.7% (29/47, P = 0.621). Thirty-six cases had neck dissection, including 2 cases with radical neck dissection, 6 cases with modified neck dissection, and 28 cases with selective neck dissection. The lymph node metastasis rate of all cases was 17.5%. Ten cases were diagnosed as postoperative local recurrence, including 1 cases treated with total laryngectomy, 2 cases treated with near total laryngectomy and 7 cases treated with partial laryngectomy.

CONCLUSIONSBoth total laryngectomy and partial laryngectomy are important surgical procedures for treating patients with T3 glottic carcinoma. The optimal individual surgical procedure for the patient with T3 glottic carcinoma should be determined on the basis of the local lesions and physical status. Total laryngectomy is prior to partial laryngectomy for the patients with T3 glottic carcinoma ≥ 70 years old.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; pathology ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; methods ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies