To compare the characteristics of the traditional Chinese medicine (TCM) syndromes of gallbladder heat attacking the stomach and stagnant heat of the liver and stomach in patients with reflux esophagitis (RE), in terms of clinical symptoms, combination of gallbladder conditions, esophageal mucosal inflammation, gastric bile reflux under endoscopy and helicobacter pylori (HP) infection.

Objective To understand the allocation of radiological diagnostic equipment and the frequency of medical radiation exposure in the medical institutions in Ningxia region,in order to provide the basis for the reasonable application of medical radiation technology.Methods The general survey in the form of the questionnaires was used to investigate and analyze the medical radiation usage of medical X-ray diagnostics,interventional radiology,nuclear medicine and radiotherapy in Ningxia region medical institutions.Results The frequency of X-ray diagnostic radiography in Ningxia region was 727.9 per 1 000 population in 2014.The frequency of X-ray photography examination was the highest,525.2 per 1 000 population,followed bv the frequency of CT scanning,147.9 per 1 000.For others,the frequency was radiotherapy 6.0 per 1 000 population,nuclear medicine 1.8 per 1 000 and interventional radiology 3.8 per 1 000,respectively.These differences were of statistical significance in frequency of X-ray diagnostic examination in five cities' medical institutions in Ningxia (X2 =162 280.7,P ＜ 0.05),also in all medical institutions at different levels (x2 =902 485.2,P ＜ 0.05) and for both frequency of X-ray photography examination and CT scanning in these institutions (x2 =471 574.9,181 887.1,P ＜ 0.05).Conclusions Of the X-ray diagnostic radiography,the CT scanning has becoine a major means next only to the X-ray photography examination.There are differences in frequency of X-ray diagnostic examination in the medical institutions at different levels in different cities of the region.The related regulatory authorities should strengthen the supervision and management of radiation protection in mnedical institutions,to ensure the justification of diagnostic radiology and radiotherapy.

Objective To evaluate the clinical efficacy and safety ofHongteng Chang'an Decoction in treating mild and moderate ulcerative colitis (UC) cases.Methods Totally 120 patients of mild or moderate UC were randomly divided into two groups:TCM group of 60 patients, treated by self-madeHongteng Chang'an Decoction;Western medicine group of 60 patients, treated by mesalazine orally. The treatment course of both groups was 6 weeks, also with two-week follow-up. The ESR and CRP levels before and after treatment, the healing of colonic mucosa under endoscopy (according to the Baron score), the clinical efficacy and safety were analyzed statistically.Results CRP of both groups decreased significantly, with obvious statistical significance (P<0.05);ESR of both groups decreased, without statistical significance (P>0.05). The effects of healing of colonic mucosa under endoscopy of TCM group and Western medicine group were 61.37% (27/44) and 64.29% (27/42), respectively, without obvious statistical significance (P>0.05). The total effective rates of TCM group and Western medicine group were 86.7% (52/60) and 75.0% (45/60), respectively, and the TCM group was superior to the Western medicine group (P<0.05).ConclusionHongteng Chang'an Decoction can reduce the serum level of CRP of the mild and moderate UC patients effectively, relieve inflammation, and promote the healing of colonic mucosa. The treatment of mild and moderate ulcerative colitis byHongteng Chang'an Decoction has good clinical efficacy, without toxic side effects.

Objective To explore the local application of immunosuppressant in improving the survival rate of the transplanted islet cells and systemic side effects.Methods The streptozocin of 200 ms/kg was injected into the abdominal cavity of the Wistar rats，the blood sugar was tested after 48，and 72 hours，and the rats with two consecutive measurements ≥20 mol/L were taken as the experimental animal model.The dose of pancreatic islet cells transplanted into the abdominal cavity was 8 000 IE,/kg，and that of cyclosporine dosage was 1.5 mg/(100 g·d).The pancreatic islet cells were divided into three groups：(1)systemic immunosuppressive agents through stomach lavage with the intraperitoneal injection of microencapsulated islet cells；(2)pure intraperitoneal injection of microencapsulated islet cells；(3)intraperitoneal injection microencapsulated activated carbon particles loaded with immunosuppressants，and mieroencapsulated islet cells.Changes of blood glucose and pathological in rats after transplantation were detected.Results The blood glucose of group 3 and group 1 showed no significant difference(P＞0.05)，as well as compared with group 2(P＞0.05).But the local application of immune agents could prolong the effective time of the islet cells and attenuate the fibrotic extent of the surrounding islets when compared with the control group,the C peptide level in applicating immunosuppressive agents group was significantly hisher in the immunosuppressive group than the pure transplantation group.ConclusionCompared with the systemic immune suppression via stomach lavage，local application of slow-release immunosuppressive agents showed the same effects of activated carbon particles，with a prolonged the effective time of islet cell and reduced topical side effects in the latter.

Objective:To investigate the effect of gemcitabine on myeloid derived suppressor cells (MDSC) in the spleen of B lymphoma cell-bearing mice, and the therapeutic effect of gemcitabine combined with intratumoral injection of dendritic cells (DCs) in treatment of large B lymphoma. Methods: BALB/c mice were inoculated subcutaneously with B lymphoma A20 cells; large tumors were formed 30 d after inoculation. Gr-1~+ CD11b~+ MDSC proportion in the spleen was analyzed by flow cytometry before and after gemcitabine treatment. Splenic MDSC sorted by immunomagnetic beads was further treated with gemcitabine, and then the apoptosis of MDSC was examined by Annexin-V/PI staining. Tumor growth and survival time of A20 tumor-bearing mice were observed after treatment with gemcitabine and intratumoral injection of DCs. Results: Splenic Gr-1~+ CD11b~+ MDSC ratio in A20 cell-bearing mice was 10 times higher than that in the normal mice. Gemcitabine induced apoptosis and necrosis of purified MDSC in vitro in a time-dependent manner. The percentage of MDSC in the spleen of A20 tumor-bearing mice was decreased after injection of a single dose of gemcitabine. Gemcit-abine or intratumoral injection of DCs alone inhibited growth of tumor to a certain degree, with the mean survival periods of mice in the gemcitabine, DCs, and untreated groups being (48.8±3.6) d, (47.2±7.4) d, and (38.8±2.2) d, respectively. Gemcitabine chemotherapy combined with intratumoral DC injection resulted in continuous shrink of the tumors, and 60% of the mice survived for more than 90 d. Conclusion: Gemcitabine can effectively eliminate splenic MDSC in tumor-bearing mice. Gemcitabine chemotherapy and DCs immunotherapy can work synergistically in the treat-ment of huge lymphoma. These results provide an experimental basis for the comprehensive chemotherapy and immunotber-apy of relapsed or refractory lymphoma.

To investigate the risk factors and clinical characteristics of postrenal transplant diabetes mellitus (PTDM), we reviewed the records of 177 renal allograft recipients in Maryknoll Hospiatal whose allografts had functioned longer than 6 months. Nineteen patients (10.7%) developed PTDM at 5.0+/-7.8 (1-52) months; 9 (47%) of these within 1 month. PTDM patients were older than nondiabetic renal transplants (42+/-2 vs 37+/-1 years, P<0.05). Body mass index tended to be higher in PTDM (23.5+/-1.0 vs 21.8+/-0.3kg/m2, P=0.09). Number of acute rejections (0.6+/-0.2 vs 0.5+/-0.1) and serum creatinine at 1 year after transplantation (1.2+/-0.8 vs 1.3+/-0.3mg/dL) were not different. Fasting (103.6+/-10.4 vs 84.4+/-1.6mg/dL, P<0.05) and postprandial (189.2+/-24.8 vs 118.6+/-2.3 mg/dL, P<0.01) blood sugars, measured before transplantation, were higher in PTDM. CsA blood level at 1 month posttransplantation was higher in PTDM (350+/-34 vs 279+/-8ng/mL, P<0.05). Fasting serum insulin was significantly higher (28.2+/-12.2 vs 7.3+/-2.0 microunit/dL, P<0.05) and serum C-peptide tended to be higher in PTDM patients compared with euglycemic renal recipients (6.3+/-1.6 vs 3.8+/-0.9ng/dL, P=0.08). All the PTDM patients were treated by either insulin or oral agent; 15 of 19 required no treatment after 4.7+/-6.9 months. In conclusion, prevalence of PTDM was 10.7%. PTDM patients were older. Body mass index was tended to be higher. Fasting and postprandial blood sugars, measured before transplantation, were higher in PTDM. Faslting serum insulin was higher and C-peptide tended to be higher in diabetics. These results suggested that increased insulin resistance plays a major role in the pathogenesis of PTDM.
Allografts ; Blood Glucose ; Body Mass Index ; C-Peptide ; Creatinine ; Cyclosporine ; Diabetes Mellitus* ; Fasting ; Humans ; Insulin ; Insulin Resistance ; Prevalence ; Risk Factors*

PURPOSE: To evaluate the incidence of sacral insufficiency fracture in osteoporotic patients with compression fracture of the thoracolumbar (T-L) spine on magnetic resonance image (MRI), and to analyze the correlation of variable clinical factors and the incidence of sacral insufficiency fracture. MATERIALS AND METHODS: We retrospectively reviewed 160 patients (27 men, 133 women; age range of 50 to 89 years) who underwent spinal MRI and had compression fracture of the T-L spine. Compression fractures due to trauma or tumor were excluded. We evaluated the incidence of sacral insufficiency fracture according to the patients' age, sex, number of compression fractures, and the existence of bone marrow edema pattern of compression fracture. During the same period, we evaluated the incidence of spinal compression fracture in the patients of pelvic insufficiency fracture. RESULTS: Out of the 160 patients who had compression fracture in the T-L spine, 17 (10.6%) had insufficiency fracture of the sacrum. Compression fracture occurred almost 5 times more frequently in women (27:133), but the incidence of sacral insufficiency fracture was 2/27 for men (7.4%) and 15/133 for women (11.3%), with no statistically significant difference (p = 0.80). According to age, the ratio of insufficiency fracture to compression fracture was 0% (0/23) in the 50's, 10.6% (7/66) in the 60's, 12.5% (7/56) in the 70's, and 20.0% (3/15) in the 80's. In respect of single and multiple compression fracture, the incidence of sacral insufficiency fracture was 8/65 for men (12.3%) and 9/95 for women (9.5%), showing no significant difference (p=0.37). In the patients with and without compression fracture with bone marrow edema, insufficiency fracture occurred in 5/76 (6.6%) and 12/84 (14.3%), respectively. On the other hand, of the 67 patients who had pelvic insufficiency fracture, 27 (40.3%) also had spinal compression fracture. CONCLUSION: About 10% of the patients with osteoporotic compression fracture in the T/L spine also had pelvic sacral insufficiency fracture, which was not uncommon. These findings suggest the need to consider the possibility of pelvic sacral insufficiency fracture in cases of T/L spinal MRI for patients with osteoporotic compression fracture.
Bone Marrow ; Edema ; Female ; Fractures, Compression* ; Fractures, Stress* ; Hand ; Humans ; Incidence* ; Magnetic Resonance Imaging ; Male ; Osteoporosis ; Retrospective Studies ; Sacrum ; Spine*

BACKGROUND: Polycythemia vera (PV) is a myeloproliferative neoplasm that can cause complications such as thrombosis and organ damage. To prevent complications of PV, therapy for maintenance of a hematocrit target of less than 45% has been recommended and phlebotomy is a simple therapy. However, the effects of phlebotomy have not been well evaluated in Korea. Therefore, we evaluated the effects of phlebotomy performed in patients with PV and secondary polycythemia. METHODS: The clinical data and phlebotomy records of 15 patients diagnosed with PV and secondary polycythemia from May 2005 to March 2013 at the National Cancer Center were reviewed retrospectively. RESULTS: Patients included 10 males and five females. The median age of patients was 63 years (range, 50~72 years). There were six PV patients (40%) and nine secondary polycythemia patients (60%). The mean number of phlebotomy attempts per patient was 6 (range, 1~22), with an interval between phlebotomy attempts of 16 weeks (range, 1~96 weeks). The mean phlebotomy volume was 458 mL, which was 10.3% of the total blood volume. After phlebotomy, the mean hematocrit showed a decline, from 50.4 (+/-4.35)% to 46.5 (+/-4.85)%, and symptoms improved. After phlebotomies, 10 patients achieved a hematocrit of less than 45% and this hematocrit level was obtained after an average of six phlebotomies. CONCLUSION: Phlebotomy is an effective treatment modality for lowering the hematocrit value in patients with PV and secondary polycythemia. However, target hematocrit was not achieved after a single phlebotomy. Therefore, adjustment of visit intervals and changes in phlebotomy volume were needed.
Blood Volume ; Female ; Hematocrit ; Humans ; Korea ; Male ; Phlebotomy* ; Polycythemia Vera* ; Polycythemia* ; Retrospective Studies ; Thrombosis

BACKGROUND: Donor granulocyte transfusion has been used as a salvage treatment for neutropenic patients with severe infection who did not respond to antibiotics. Here we investigated hematological parameters of granulocyte collection to evaluate its efficacy and safety. METHODS: The clinical data for 92 procedures of granulocyte collection performed on 82 healthy donors from April 2007 to July 2014 at National Cancer Center were reviewed retrospectively. Healthy donors were pre-medicated 12 hours before apheresis with subcutaneous injection of 600 microg of granulocyte-colony stimulating factor (G-CSF) with or without 8 mg of oral dexamethasone. Blood cell counts of donors at the time of pre- and post- granulocyte collection state of donors were investigated and any clinical symptoms and signs were monitored during the procedure. RESULTS: he median age was 29 years old (range, 18~52). The mean of collected granulocyte volume was 230 mL, and the granulocyte yield in apheresis products was 4.90x10(10) (1.46~7.86). Granulocyte yields showed significant correlation with volume of granulocyte collection, total processing volume, pre-WBC count, and pre-ANC. Granulocyte yields of dexamethasone and G-CSF administration were greater than with G-CSF administration alone. Pain (low back, hip, knee, and whole body), insomnia, fatigue, abdominal discomfort, and/or headache occurred in 21% of donors during mobilization. CONCLUSION: Granulocyte mobilization was safe and effective, and is well-tolerable in healthy donors because collection was possible in all donors without complications of G-CSF and dexamethasone administration and apheresis.
Anti-Bacterial Agents ; Blood Cell Count ; Blood Component Removal ; Dexamethasone ; Fatigue ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Headache ; Hip ; Humans ; Injections, Subcutaneous ; Knee ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders ; Tissue Donors*