1.Video-assisted thoracoscopic mini-invasive lobectomy: A clinical analysis of 35 cases
Hongdu ZHANG ; Ying FANG ; Shuangcheng FENG
Chinese Journal of Minimally Invasive Surgery 2001;0(05):-
Objective To assess the value of video-assisted thoracoscopic mini-invasive lobectomy in the treatment of pulmonary benign lesions or malignancies. Methods A retrospectively analysis on clinical data of 35 cases of video-assisted thoracoscopic mini-invasive lobectomy, which were performed from February 2002 to June 2006, was made. The pathological diagnosis included 31 cases of peripheral lung cancer (T_1N_0-1M_0), 3 cases of bronchiectasis, and 1 case of atelectasis combined with pulmonary abscess. The procedures included 30 cases of anatomical lobectomy and 5 cases of non-anatomical lobectomy. Results No conversion to open surgery was required. The operation time was 85~210 min (115?35 min) and the intraoperative blood loss was 150~450 ml (210?55 ml). Postoperatively, acute respiratory failure was encountered in 2 cases, and mechanical ventilation was given for 3 and 5 days, respectively. Acute myocardial infarction occurred in 1 case, which was cured by early-stage thrombolysis. No postoperative complications were seen in the remaining 32 cases. The closed chest drainage was maintained for 2~10 days (mean, 5.4 days). In 3 cases of pulmonary benign lesions, follow-up checkups for 41, 33, and 13 months, respectively, found no long-term complications. In 25 cases of lung cancer, follow-up observations were made for 3~53 months (mean, 15.2 months), including 3~12 month in 6 cases, 12~24 months in 9 cases, 24~36 months in 7 cases, and 36~53 months in 3 cases. There were 4 cases of death due to cancer recurrence or metastasis (16%), 2 cases of with-tumor survival (8%), and 19 cases of disease-free survival (76%), respectively. Conclusions Video-assisted thoracoscopic mini-invasive lobectomy is a feasible and safe procedure for peripheral lung cancer and benign lung diseases.
2.A REPORT OF TWO CASES OF INCOMPLETE REGRESSION OF VENTRAL MESOGASTRIUM
Hongdu ZHANG ; Guanliang LU ; Shujuan SHI ; Wen SHEN ; Ghanghan ZHANG ; Shaotian SUN ; Anrong ZHANG
Acta Anatomica Sinica 1953;0(01):-
Two cases of incomplete regression of ventral mesogastrium were reported. Their nomenclature, etiology, symptoms and characteristic roentgenologic findings were discussed in relation to anatomical study. Because of its unique etiology and symptoms, charecteristic roentgenologic findings, and effectual remedy, it is suggested that this disease should be distinguished from "abnormal adhesion of fibrous bands" as an independent anomaly called incomplete regression of ventral mesogastrium. The roentgenological findings were: An incisure was found in the upper portion of pars descendens duodeni. It sank deeply and reduced two thirds of the normal diameter of the intestinal lumen to form an eccentrie intestinal stenosis. The intestinal lumen, near the inner border of the incisure was smooth, and there was no sign of serrated image formed by intestinal mucosa. The part of intestinal lumen was not distended in hypotonic radiography. All the above signs were caused by the traction and binding of the nonregressed mesogastrium.
3.Effect of Qingre Huashi Sanjie Enema Prescription on MCP-1,TGF-β1,IL-6,and T Lymphoid Subsets in Patients with Sequelae of Pelvic Inflammatory Disease with Syndrome of Combined Dampness, Heat, and Stasis
Wenxiao CHEN ; Chen ZHANG ; Xijing YU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(17):138-144
ObjectiveTo investigate the application value of Qingre Huashi Sanjie enema prescription in the treatment of the patients with sequelae of pelvic inflammatory disease (syndrome of combined dampness,heat,and stasis) and the effects of this prescription on inflammatory mediators and T lymphocyte subsets. MethodThe patients with sequelae of pelvic inflammatory disease (syndrome of combined dampness,heat,and stasis) treated from May 2022 to August 2023 were included in this study and randomized into two groups (79 cases). The control group was treated with conventional Western medicine,and the observation group was treated with Qingre Huashi Sanjie enema prescription on the basis of the therapy in the control group. Both groups were treated for 12 weeks. The serum levels of monocyte chemoattractant protein-1 (MCP-1),transforming growth factor-β1 (TGF-β1),and interleukin-6 (IL-6) were measured by enzyme linked immunoserbent assay (ELISA) before and after treatment in both groups. The erythrocyte sedimentation rate (ESR) and fibrinogen (FIB) were measured by an automatic blood rheology analyzer before and after treatment in both groups. The serum levels of CD4+,CD4+/CD8+ before and after treatment in both groups were measured by flow cytometry. The traditional Chinese medicine (TCM) symptom score and the 36-item short form survey (SF-36) score were assessed before and after treatment. The uterine artery resistance index (RI),uterine artery pulsatility index (PI),and uterine artery peak systolic velocity (PSV) were measured by Doppler before and after treatment. The clinical efficacy and the occurrence of adverse reactions were compared between the two groups. ResultAfter treatment,the levels of MCP-1,TGF-β1,IL-6,ESR,and FIB decreased in both groups (P<0.01),and the decreases were larger in the observation group than in the control group (P<0.05,P<0.01). After treatment,the serum levels of CD4+ and CD4+/CD8+ elevated in both groups (P<0.01) and the observation group had higher levels of CD4+ and CD4+/CD8+ than the control group (P<0.05,P<0.01). The treatment in both groups decreased the TCM symptom score and TCM sign score and increased the SF-36 score (P<0.01),and the changes were more significant in the observation group than in the control group (P<0.05,P<0.01). In addition,the treatment lowered RI and PI and elevated PSV (P<0.01),and the changes in these indicators were more significant in the observation group than in the control group (P<0.01). The total response rate in the observation group was 93.67% (74/79),which was higher than that (79.75%,63/79) in the control group (χ2=6.645,P<0.05). There was no significant difference in the occurrence of adverse reactions between the two groups. ConclusionFor the patients with sequelae of pelvic inflammatory disease (syndrome of combined dampness,heat,and stasis),Qingre Huashi Sanjie enema prescription can reduce inflammation,attenuate hypercoagulability,improve hemodynamics,and regulate the immune function,demonstrating a definite therapeutic effect.
4.Analysis of Medication Rules of TCM Prescription against Primary Hepatic Carcinoma Based on TCM Data Analysis Platform Based on Strategy Pattern
Shumao PAN ; Xinyou ZHANG ; Diyao WU ; Yongkun GUO ; Liang DING ; Rongzhen TAN
China Pharmacy 2020;31(24):2966-2973
OBJECTIVE:To estab lish“TCM Data Analysis Platform Based on Strategy Pattern ”(TCMDP),and to analyze the medication rules of TCM prescription against primary hepatic carcinoma (PHC),so as to provide reference for TCM prescription screening. METHODS :According to the idea of strategy pattern ,TCMDP software was developed ,and the frequency statistics,association,clustering,classification and other methods and the different algorithms covered were encapsulated. Effective TCM prescriptions against PHC were collected and screened from 4 tertiary-grade class-A hospitals in Nanchang city and CNKI , PubMed. A database of prescriptions for PHC (PDOPHC)was established ,and TCM prescriptions in the data base were put into TCMDP. Clustering algorithm modified by CMC-DD ,modified WD-Get Rules algorithm after merging depth and width search and frequency statistics were used to analyze the distribution of prescription syndrome. Taking phlegm-blood stasis syndrome type (TYPHC)as example ,data mining was carried out on drug efficacy category ,four properties ,five flavors and channel tropism , drug property combination ,key couplet medicines and key drug combination. RESULTS :A total of 907 TCM prescriptions against PHC were collected ,mainly involving 10 syndrome types ,such as phlegm-blood stasis syndrome ,deficiency of the vital essential and blood stasis syndrome and liver and spleen blood stasis syndrome. TCM related to TYPHC commonly used in pre- scriptions were tonifying deficiency medicine , phlegm-re- solving medicine ,promoting blood circulation and removing blood stasi s medicine ,etc.Four properties were mostly cold ,warm and calm ;the five flavors were most ly swe et,bitter and pungent ;channel tropism were mostly spleen ,liver,stomach, lung,heart and kidney ;drug combination were mostly warming-sweet-spleen ,warming-pungent-spleen and cold-bitter-liver ,etc.; there were 36 couplet medicines with frequency ≥30 times;there were 31 strong association rules and 8 key drug combinations in the prescriptions. WD-Get Rules results showed that in the TCM prescriptions against PHC ,Atractylodes macrocephala ,Codonopsis pilosula,Poria cocos and Glycyrrhiza uralensis were in the key position. They were often combined with many kinds of drugs , which were related to the effect of Sijunzi decoction on strengthening Qi and tonifying spleen. CMC-DD results showed that therapy for TYPHC focused on strengthening the spleen and stomach ,replenishing Qi and blood ;and at the same time ,it treated TYPHC with phlegm-blood stasis syndrome from multiple angles ,such as soothing the liver and regulating Qi ,eliminating phlegm ,clearing heat and detoxification ,promoting blood circulation and nourishing Yin. CONCLUSIONS :Clinical treatment of TYPHC mainly adopts the methods of invigorating the spleen and replenishing Qi ,soothing the liver and regulating Qi ,promoting blood circulation and removing blood stasis ,which conforms to the medication principle of “strengthening the body and eliminating pathogenic factors”. The application of TCMDP can realize the data mining and analysis of TCM in multi-level and multi-directional way , which provides a new and effective way for the mining and research of compatibility rules of TCM prescriptions.
5.Meta-analysis of Oral Chinese Medicine for Adjuvant Treatment of Primary Hepatic Carcinoma and Screening of Basic Chinese Herbs
Xin-you ZHANG ; Shu WANG ; Shu-mao PAN ; Di-yao WU ; Rong-zhen TAN ; Xiu-yun LI ; Meng-ling LIU ; Liang DING
Chinese Journal of Experimental Traditional Medical Formulae 2021;27(20):180-190
Objective:To systematically evaluate the efficacy of oral Chinese herbal prescriptions combined with transcatheter arterial chemoembolization (TACE) against primary hepatic carcinoma (PHC) and screen the basic Chinese herbs,in order to provide certain reference for clinical medication. Method:The randomized controlled trials concerning the treatment of PHC with oral Chinese herbal prescriptions plus TACE were retrieved from CBM,China National Knowledge Infrastructure (CNKI),Chongqing Weipu Database for Chinese Technical Periodicals (VIP),and Wanfang Data Knowledge Service Platform.The quality of the included trials was evaluated by Cochrane handbook,and the Meta-analysis was performed using RevMan 5.3.The enumeration data were expressed by odds ratio (OR),the measurement data by mean difference (MD) or standardized mean difference (SMD),and the effect size by 95% confidence interval (CI).The data of oral Chinese herbal prescriptions involved in trials were sorted out and subjected to association rule analysis and frequency analysis based on the Traditional Chinese Medicine Inheritance Support System (TCMISS),for exploring the basic Chinese herbs and their dosages against PHC. Result:A total of 75 randomized controlled trials were included,involving 7 406 cases. As revealed by the Meta-analysis,oral Chinese herbal prescriptions combined with TACE was significantly better than TACE alone in improving the short-term curative effect [OR=2.05,95%CI(1.83,2.29)],decreasing alpha fetoprotein (AFP) [MD=-59.02,95%CI(-79.03,-39.01)],ameliorating liver function [SMD=-1.23,95%CI(-1.58,-0.88)],boosting immunity [SMD=1.08,95%CI(0.84,1.32)],adjusting Karnofsky Performance Status (KPS) scale score [OR=2.7,95%CI(1.11,11.02)],elevating survival rate [OR=2.31,95%CI(1.96,2.71)],and reducing adverse reactions [OR=0.38,95%CI(0.34,0.43)].Data mining results showed that the basic Chinese herbs against PHC were Bupleuri Radix,Paeoniae Alba Radix,Atractylodis Macrocephalae Rhizoma,Poria,and Glycyrrhizae Radix et Rhizoma,with their clinical dosages listed as follows:6-15 g for Bupleuri Radix,10-15 g for Paeoniae Alba Radix,9-15 g for Atractylodis Macrocephalae Rhizoma,10-15 g for Poria,and 3-10 g for Glycyrrhizae Radix et Rhizoma. Conclusion:The oral Chinese herbal prescriptions combined with TACE produce better effects in treatment of PHC as compared with TACE alone.These five basic Chinese herbs have anti-cancer effect,and their dosages are within the ranges stipulated in 2020 edition of