Thirty-four cases of hyperlipidemia were treated by embedding No.0 catgut in 2cm length into bilateral Zusanli (ST 36) and Jiaji (Ex-B 2) of the tenth thoracic vertebra and were compared with 30 cases treated by oral administration of Pravastatin. After two months, the acupoint catgut-embedding method had the same effect as Pravastatin in reducing total serum cholesterol, and had a better effect in reducing triglyceride.

Objective To analyze the correlation between serum lipoprotein associated phospholipase A 2(Lp‐PLA2) with five traditional inflammatory factors of TC ,TG ,LDL‐C ,hs‐CRP and Hcy in the patients with coronary heart disease(CHD) ,and to in‐vestigate the relationship between its concentration with the lesions and severity of CHD .Methods Two hundreds cases of CHD were selected as the lesion group(which was subdivide into single vessel lesion ,double vessel lesion and three vessel lesion) ,at the same time ,100 persons undergoing physical examination were selected as the control group .The correlation between Lp‐PLA2 with five traditional inflammatory factors of TC ,TG ,LDL‐C ,hs‐CRP and Hcy was analyzed .The differences of Lp‐PLA2 in the lesion group and the control group were compared and the relation between Lp‐PLA2 level with lesion vessels number was analyzed .Re‐sults Lp‐PLA2 was significantly correlated with LDL‐C ,Hcy ,TC and hs‐CRP(P<0 .05) and had no relation with TG(P>0 .05) , the level of Lp‐PLA2 in the lesion group was significantly higher than that in the control group (P<0 .01) ,the Lp‐PLA2 level was elevated with the number of coronary lesion vessels ,but the correlation is unobvious(P>0 .05) .Conclusion High concentration of Lp‐PLA2 is a risk factor for coronary atherosclerosis ,but the correlation between the Lp‐PLA2 level and the severity of coronary arterial lesion needs further study .

Objective To evaluate continuous improvement of portable domestic pelvic floor neuromuscular electrical stimulation on the pelvic floor function of patients with stress urinary incontinence after short-term pelvic floor electrophysiological treatment in hospital.Methods Totally 60 women with stress urinary incontinence were recruited for this randomized controlled trial.The control group including a total of 30 patients,only received 4 weeks pelvic floor electrophysiological treatment in the hospital.Family consolidation treatment group (experimental group) including 30 patients,after 4-week treatment in hospital,received 12-week of pelvic floor neuromnuscular electrical stimulation using portable electrical stimulator at home under the guidance of doctors.In post-treatment 6 months and 9 months,1-hour pad test was measured for urine leakage,pelvic floor electrical physiological parameters were assessed,and subjective improvement of symptoms of urinary incontinence were evaluated.All these data were analysed to compare the effect of the two groups.Results In 9 months after treatment,average change of urine leakage,the control group and experiment group were (75±24)％ versus (99±3)％,the difference was statistically significant (P＜0.01).In the experiment group,strength of type Ⅰ muscle (4.4±0.7),strength of type Ⅱ muscle (4.8±0.4) and pelvic floor dynamic pressure [(96± 12) cmH2O,1 cmH2O=0.098 kPa] were better than those of control group [3.2± 1.0,4.3 ± 0.9,(86 ± 10) cmH2O,respectively],the differences were statistically significant (P＜0.01).Subjective outcome,the control group and experiment group were (6.5 ±2.9) versus (1.8 ± 1.7),subjective outcome between the two groups had significant difference (P＜0.01).Conclusion After short-term pelvic floor electrophysiological treatment in hospital,the portable domestic pelvic floor neuromuscular electrical stimulation in patients with stress urinary incontinence is helpful to continuous improvement of pelvic floor function.

Objective To evaluate clinical and sexual outcomes in women with severe uterine prolapsed at child-bearing period undergoing laparoscopic high uterosacral ligament suspension combined with cervical amputation.Methods From November 2007 to March 2010,34 patients (≤50 years old) with severe uterine prolapse (prolapse group) who had already given birth and underwent laparoscopic high uterosacral ligament suspension combined with cervical amputation in Peking Union Medical College Hospital were enrolled in this retrospective study.All patients were defined as Pelvic Organ Prolapse Quantification (POP-Q) stage Ⅲ.Follow-up was performed at 1,6,and 12 months,and then annually.Anatomic failure was defined as ≥ 1 pelvic compartment classified as POP-Q ≥ stage Ⅱ.Sexual outcomes were assessed at baseline and 3-year follow-up according to validated Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).Thirty one age-matched women who underwent health examinations during the same time period were selected as a healthy control group.Results Mean age of women at prolapse group were (39 ±5) years and average surgery time were (51 ±8) minutes.No severe intraoperative complications occurred,including urethral twist,bladder and rectum injury,pelvic hemotoma.All patients were followed up for more than 3 years,the mean following up period was 40 months (36-64 months).Based on stage Ⅱ of POP-Q as recurrence criteria,the anatomical success and patient satisfaction rates were both 100％ (34/34).POP-Q point C and D measurements were significantly higher after surgery then those at preoperative values [C:(-5.4±0.6) cm versus (2.2 ±0.7) cm,D:(-6.7 ±0.4) cm versus (-4.0 ±0.7) cm; P ＜0.01 for all].Three years postoperatively,33 patients were sexually active.Among the 94％ (31/33) patients who answered the PISQ-12 questionnaire,there was significant improvement in post-and preoperative total PISQ-12 scores (38 versus 26,P ＜ 0.01) and in all three subscale PISQ-12 domains (P ＜ 0.01 for all).The postoperative PISQ-12 score was similar to that of the control group (38 ± 6 versus 37 ± 3,P ＞ 0.05).Conclusion Laparoscopic high uterosacral ligament suspension combined with cervical amputation conferred satisfying long-term anatomic and sexual function outcomes in women at child-bearing age.

Objective To evaluate the medium and long term safety and efficacy of sacrospinous ligament fixation (SSLF) performed with conventional instruments in treating stage Ⅲ-Ⅳ pelvic organ prolapse (POP).Methods A prospective cohort analysis was conducted in the Peking Union Medical College Hospital,between May 2007 and June 2015,enrolling 55 women with stage Ⅲ-Ⅳ POP who intended to receive SSLF.Primary end points were objective success rates using pelvic organ prolapse quantitation system (POP-Q) and subjective satisfaction rates with questionnaires after surgery according to vaginal examination and related questionnaires for all patients who received SSLF eventually.Exploratory outcomes included perioperative parameters and complications.Results Of these 55 POP patients enrolled,52 (95％,52/55) received SSLF using conventional surgical instruments,the other 3 cases converted to ischial spinous fascia fixation due to difficulty exposing.Medium blood loss during operation was 100 ml (20-300 ml) and operative time 60 minutes (20-165 minutes).Pelvic hematoma with diameters of 5 cm and 7 cm were observed in two patients,both recovered fully with conservative methods.All patients were able to micturate spontaneously after catheter withdrawal.One patient reported right thigh pain after operation which remained till 3-month follow-up and relieved after physiotherapy.The objective success rate was 100％ (52/52) at 3 months.With a medium follow-up time of 23.7 months,the objective success rate was 98％ (51/52),the recurrence rate was 2％ (1/52) and the satisfactory rate was 94％ (49/52).De novo urinary incontinence occurred in 6％ (3/52) of patients.Conclusion Most POP could be corrected with SSLF using conventional instruments which is a feasible,economic and effective procedure for Asian patients with medium compartment prolapse.

ObjectiveTo evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage Ⅲ.Methods From July 2010 to December 2011,31 patients with POP stage Ⅲ undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study.Among two cases complicated with stress urinary incontinence underwent transobturator tension-freevaginaltapeconcomitantlywithtotalpelvicreconstructionsurgerywith Prosima.Clinical parameters during peri-operation were recorded and compared.Pelvic organ prolapse quantitative examiuation(POP-Q)andanatomicimprovementinthesepatientsafter surgery were analyzed.Comparisons of pelvic floor impact questionnaire-short form 7 ( PFIQ-7 ) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.ResultsThe mean operating time was (55 ± 13) minutes,mean blood loss was (66 ± 25 ) ml.No severe intraoperative complications were observed.All patients were able to recover spontaneous mieturation within 5 days.Two cases experienced pelvic hematoma with diameters less than 7 cm,and resolved later.Another case was urinary tract infection.At the median follow-up 6 months ( 1 - 15 months),the rate of anatomic success defined as the leading vaginal edge above the hymen was 94％ (29/31).There were significant improvements in Aa,Ba,Ap,Bp,and C (P ＜0.01 ) by POP-Q.Two patients showed recurrent prolapse at 3 months and 1 year after surgery,without the need of further operation.The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation,respectively,which were significantly lower than that of 50 points pre-operation ( P ＜ 0.01 ).And there was no significant difference in the average score of PISQ-12 before and after surgery [ ( 30 ± 6) points versus (31 ± 4) points ] ( P ＞ 0.05 ).The rate of mesh exposure was 16％ ( 5/31 ),all the 5 cases occurred within 6 months and was cut in clinic.There was no case of de novo urinary incontinence and de novo dyspareunia.Conclusions Pelvic rcconstruction surgery with Prosima is safe and efficacy in treatment of POP stage Ⅲ.It could improve quality of life remarkably without influence on sexual quality of life.

Objective To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage Ⅲ pelvic organ prolapse (POP).Methods Between March 2007 and December 2009,65 patients with stage Ⅲ POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study.Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly.Clinical parameter associated with perioperation,objective and subjective successful rate and complication were recorded.Results The mean operating time was (71 ±22) min and the mean blood loss was (93 ±40) ml.No intraoperative blood transfusion and viscera injury cases were observed.All patients were able to recover spontaneous micturition.Two cases experienced pelvic hematoma with diameter of 7 cm,after conservative treatment,they all recovered later.The objective success rate was 100％ at 6 weeks follow-up by POP-Q scoring.And 46.2％ (30/65) were followed up at range of 1 -3 years,recurrence rate were 10％ (3/30),and however,no operation were needed.At median of 20 months,all patients were followed up by telephone,the subjective successful rate was 95.4％ (62/65).At 6 weeks after operation,6.2％ (4/65) patients suffered from lower back pain and right thigh pain,visual analogue scale of pain was at range of 3 to 5,which relieved gradually after treatment and disappeared totally within 2 years.The rate of suture exposure was 10％ (3/30),the new urinary incontinence 4.6％ (3/65),and the new dyspareunia 12.5％ (3/24).Conclusions Ischiospinous ligament fixation is a safe and efficacious management.

Objective To investigate the clinical features, diagnosis and treatments of pelvic abscess with endometriosis. Methods A retrospective analysis was performed on 129 cases of pelvic abscess in Peking Union Medical College Hospital from January 2000 to January 2016. Among them, 34 women with endometriosis were divided into the study group and the others were in the control group. The clinical characteristics, therapeutic regimens and outcomes were compared. Results (1) General conditions:there were no statistic differences between the two groups in age, WBC, serum CA125, intrauterine device in use, pelvic inflammatory disease history;while incidence rates of dysmenorrhea (65%, 22/34) and infertility (21%, 7/34) in the study group were higher than those in the control group (all P<0.05). (2) Clinical manifestations:fever, abdominal pain and pelvic mass were the main symptoms in two groups. The incidence rates of septic shock were 12%(4/34) in the study group and 2%(2/95) in the control group (P<0.05). (3) Treatment:treatment with puncture all failed in the study group (7/7) and surgeries were required. In contrast, there was only 1/19 treatment failure with puncture in the control group. The puncture failure rates were statistically significant (P<0.05). Compared with the study group and the control group, there were significant differences (P<0.05) in the operation time of laparoscopic surgery [(76±41) versus (53±21) minutes] and of laparotomy [(168±58) versus (116±35) minutes], intra-operative blood loss of laparoscopic surgery [(216±296) versus (43±36) ml] and of laparotomy [(448 ± 431) versus (145 ± 24) ml]. Conclusions Pelvic abscess in women with endometriosis is more severe and refractory to antibiotics and puncture treatment. Active surgical intervention is required. Although surgical procedures are often difficult, prognosis is comparatively satisfied.

OBJECTIVETo systematically evaluate the efficacy and safety of diammonium glycyrrhizinate enteric-coated capsules versus diammonium glycyrrihizinate in patients with chronic viral hepatitis.

METHODSThe Chinese Biomedical Literature Database (CBM on CD-ROM) and the China Academic Journals Full-Text Database (Chinese National Knowledge Infrastructure, CNKI) were searched for randomized controlled trials (RCTs) that compared the efficacy and safety of diammonium glycyrrhizinate entetic-coated capsules versus diammonium glycyrrihizinate in treatment (less than 2 months) of chronic viral hepatitis published between 2005 and 2012. A meta-analysis was performed on the selected RCTs to determine the effects on alanine aminotransferase (ALT) normalization, serum levels of ALT, aspartate aminotransferase (AST), total bilirubin (TBil) and albumin, as well as rates of adverse reactions.

RESULTSNine RCTs, involving 687 patients, were included in the meta-analysis. Compared to the patients treated with diammonium glycyrrihizinate, the patient treated with diammonium glycyrrhizinate enteric-coated capsules had a significantly better recovery rate of ALT (relative risk (RR) =4.15, 95% confidence interval (CI):1.55 to 11.15, P less than 0.01) and significantly more robust decreases in ALT (weighted mean difference (WMD) = -32.75, 95% CI:-46.67 to-18.83, P less than 0.01) and AST (WMD = -12.70, 95% CI:-21.13 to-4.27, P less than 0.01). In contrast, the patients treated with diammonium glycyrrihizinate showed more robust improvements in the TBil level (WMD = -0.74, 95% CI:3.98 to 2.49, P =0.653) and albumin (WMD =1.03, 95% CI:-1.03 to 3.09, P =0.326), but the differences did not reach the threshold for statistical significance (P less than 0.05). Only four adverse reactions were reported, all of which were related to the lipid complex nature of the diammonium glycyrrhizin enteric-coated capsules and were mild, including dry mouth, dizziness and mild gastrointestinal discomfort and reactions.

CONCLUSIONDiammonium glycyrrhizinate enteric-coated capsules elicited superior anti-inflammatory and liver protection effects than diammonium glycyrrihizinate, and produced only mild side effects that are tolerable to the patients.

Capsules ; Glycyrrhizic Acid ; administration & dosage ; therapeutic use ; Hepatitis, Chronic ; drug therapy ; Hepatitis, Viral, Human ; drug therapy ; Humans ; Randomized Controlled Trials as Topic

OBJECTIVE: To compare clinical efficacy of platelet-rich plasma (PRP) and extracorporeal shock wave in treating chronic insertional Achilles tendinopathy. METHODS: From February 2019 to August 2021, 42 patients with chronic insertional Achilles tendinopathy were selected and divided into PRP group(20 patients, 28 feet) and shock wave group (22 patients, 29 feet). In PRP group, there were 12 males and 8 females, aged 47.00(28.00, 50.75) years old, and the courses of disease ranged 7.00(6.00, 7.00) months;PRP injection was performed in the Achilles tendon stop area of the affected side. In shock wave group, there were 16 males and 6 females, aged 42.00(35.75, 47.25) years old;and the courses of disease was 7.00(6.00, 8.00) months;shock wave was performed in Achilles tendon stop area of the affected side and triceps surae area. Visual analogue scale (VAS) and Victorian Institute of Sport Assessment-Achilles (VISA-A) were applied to evaluate clnical effect before treatment, 1, 3 and 6 months after treatment, and satisfaction of patients was investigated. RESULTS: VAS and VISA-A score in both groups were significantly improved at 1, 3 and 6 months after treatment than before treatment (P<0.05), VAS and VISA-A score in PRP group at 6 months after treatment were significantly higher than those at 1 and 3 months after treatment, and VAS and VISA-A score in shock wave group were lower than those at 1 and 3 months after treatment (P<0.05). There was no significant difference in VAS and VISA-A score between two groups before treatment, 1 and 3 months after treatment(P>0.05), while VAS and VISA-A score in PRP group were better than those in shock wave group at 6 months after treatment(P<0.05), and the satisfaction survey in PRP group was better than that in shock wave group(P<0.05). CONCLUSION PRP injection has a good clinical effect on chronic insertional Achilles tendinopathy with high patient satisfaction, and medium-and long-term effect of PRP injection for the treatment of chronic insertional Achilles tendinopathy is better than that of extracorporeal divergent shock wave.
Male ; Female ; Humans ; Middle Aged ; Achilles Tendon ; Tendinopathy/therapy* ; Treatment Outcome ; Exercise Therapy ; Platelet-Rich Plasma