1.Clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy
Mengfan PENG ; Gang DONG ; Zhaorui WANG ; Lulu SUN ; Shanshan ZHANG ; Yuang ZHANG
Chinese Journal of Ultrasonography 2021;30(4):312-316
Objective:To investigate the clinical efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of ectopic pregnancy.Methods:A retrospective analysis was performed on 8 patients with ectopic pregnancy admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. Contrast ultrasonography was performed immediately after the operation to observe the changes of pregnancy sac. The length of hospital stay, mass absorption time and menstrual recovery time of the patients were recorded. Postoperative complications and serum human chorionic gonadotropin (HCG) negative conversion time were observed. At 3 months after the operation, hysterosalpingography was performed 3-7 days after the menstruation to observe the patency of the fallopian tubes, all patients were followed up for 1 year to observe the postoperative intrauterine pregnancy and re-ectopic pregnancy.Results:All the 8 patients were successfully treated with radiofrequency ablation, and postoperative ultrasonography showed that the mass remained unenhanced. The length of hospital stay was (3.0±0.8)d. The packet absorption time was (32.4±14.3)d. The recovery time of menstruation was (39.6±2.7)d. There were no serious complications.Blood HCG levels decreased rapidly within a week, and all returned to normal level of non-pregnancy 2-3 weeks after the operation. Three months after the operation, the salpingogram showed that the fallopian tubes were recanalized in 3 patients. After a follow-up of 1 year, 1 patient had a natural intrauterine pregnancy, and there was no case of recurrent ectopic pregnancy.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation is effective in the treatment of ectopic pregnancy with minimal trauma and rapid recovery, and can retain the reproductive ability of patients to some extent, which is worth popularizing in clinical application.
2.Ultrasound-guided radiofrequency ablation for treatment of gallbladder polyps
Gang DONG ; Shanshan ZHANG ; Lulu SUN ; Tingting LIU ; Jie WU ; Mengfan PENG
Chinese Journal of Hepatobiliary Surgery 2021;27(4):279-282
Objective:To study the safety and efficacy of ultrasound-guided radiofrequency ablation in treatment of gallbladder polyps.Methods:The clinical data of 13 patients who underwent ultrasound-guided radiofrequency ablation for gallbladder polyps at the First Affiliated Hospital of Zhengzhou University from April 2019 to March 2020 were retrospectively analyzed. These were 8 males and 5 females, with ages ranging from 20 to 49 years. The incidence of adverse reactions and complications after treatment, the complete ablation rate of polyps and the absorption of postoperative lesions were studied, and the gallbladder systolic function of patients before and after treatment were compared.Results:Of 13 patients, surgery was successfully carried out and there was no serious complications of gallbladder perforation, bleeding and collateral organ injury. The median radiofrequency ablation time was 30 s, and the complete ablation rate was 100.0%(13/13). After 6 months of follow-up, the rate of reduction of lesion volume was 100.0(98.0, 100.0)% at 6 months after surgery, which was significantly higher than the rates of 46.0(40.0, 54.0)%, 72(64.0, 100.0)% and 87.0(81.0±100.0)% at 1, 2 and 3 months after surgery ( P<0.05). The gallbladder contractility rate at 3 months after operation was (78.38±10.83)% compared with that before operation (77.46±11.28)%, and there was no significant difference ( P>0.05). Conclusion:Ultrasound-guided radiofrequency ablation for gallbladder polyps was safe. It had a significant short-term efficacy for treatment of gallbladder polyps.
3.Ultrasound-guided transgluteal puncture and catheter drainage in the treatment of deep pelvic abscess with pelvic adhesion
Tingting LIU ; Lulu SUN ; Shanshan ZHANG ; Mengfan PENG ; Shicheng QIN ; Gang DONG
Chinese Journal of Ultrasonography 2022;31(4):325-331
Objective:To investigate the safety and efficacy of transgluteal ultrasound-guided puncture and drainage in prone position in the treatment of deep pelvic abscess with pelvic adhesion.Methods:A total of 24 cases of deep pelvic abscess with pelvic adhesion treated in the ultrasound intervention room of the First Affiliated Hospital of Zhengzhou University from October 2018 to May 2021 were selected.Ultrasound-guided puncture and drainage were performed through the buttocks. The operation time, blood loss and distal limb pain during the operation were recorded. The decreasing trend of body temperature, the white blood cell, C-reactive protein and abscess size were observed. The incidence of complications such as bleeding, pain, infection and intestinal injury were counted.Results:There were 28 abscesses in 24 patients were successfully intubated through the buttocks, the abscesses disappeared after drainage, and there were no serious complications after operation. During the follow-up of 3-22 months, there was no abscess recurrence and no long-term complications.Conclusions:Ultrasound-guided transgluteal puncture and drainage is safe and effective in the treatment of deep pelvic abscess with pelvic adhesion.
4.Clinical efficacy of percutaneous radiofrequency ablation in the treatment of gestational trophoblast tumor
Gang DONG ; Shanshan ZHANG ; Lulu SUN ; Jie WU ; Tingting LIU ; Mengfan PENG
Chinese Journal of Ultrasonography 2020;29(9):786-789
Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation for gestational trophoblast tumor.Methods:The clinical data of 5 patients with gestational trophoblast tumor treated by ultrasound-guided percutaneous radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were retrospectively analyzed, the postoperative complications, changes in blood human chorionic gonadotropin (hCG), and the volume reduction rate of ablation lesion at 1, 3, and 6 months after surgery were observed.Results:None of the 5 patients with gestational trophoblast tumor had postoperative complications.Blood hCG decreased to normal level on 7 d, 8 d, 8 d, 12 d and 26 d, respectively. The volume reduction rates of ablation lesions 1, 3 and 6 months after operation in cases 1-5 were respectively 34.7%, 62.5%, 87.5%; 45.3%, 60.4%, 84%; 85.6%, 89.9%, 92.2%; 38.3%, 72.6%, 85.5%; 40.8%, 57.3%, 87%.Conclusions:Percutaneous radiofrequency ablation is minimally invasive, low risk, safe and effective treatment for gestational trophoblast tumors.
5.Efficacy analysis of ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma
Yuang ZHANG ; Qinying LI ; Gang DONG ; Lulu SUN ; Jiamin SUN ; Shanshan ZHANG ; Mengfan PENG
Chinese Journal of Ultrasonography 2022;31(2):129-134
Objective:To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma.Methods:A retrospective analysis was performed on 7 patients with nonmetastatic pheochromocytoma admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020, all of whom underwent ultrasound-guided percutaneous radiofrequency ablation. The changes of postoperative blood pressure, improvement of symptoms, intraoperative and postoperative complications were observed.Plasma free methoxypinephrine (MN) and normetanephrine (NMN) levels were recorded before and 2 weeks after operation. The reduction rate of ablation lesion volume at 1, 3 and 6 months after operation was calculated.Results:Postoperative blood pressure of all 7 patients was reduced to the normal range within 3 days, and symptoms such as headache were significantly relieved immediately after operation.No serious complications occurred during or after operation. Plasma free MN and NMN levels decreased to normal levels 2 weeks after operation. The mean reduction rates of the ablation lesions at 1, 3 and 6 months after operation were (46.61±13.42)%, (67.21±10.54)% and (85.73±4.15)%, respectively. Postoperative follow-up of 12-30 months showed that the blood pressure, plasma free MN and NMN levels of the patients were all in the normal range, and no symptoms such as headache and palpitation occurred again. All the tumors were completely ablated, and no recurrence was observed.Conclusions:Ultrasound-guided percutaneous radiofrequency ablation in the treatment of nonmetastatic pheochromocytoma is minimally invasive, safe and effective, and can retain adrenal cortex function, which is worthy of clinical promotion.
6.Efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the treatment of complex lymphatic malformations in children
Yu′ang ZHANG ; Gang DONG ; Jie WU ; Jiamin SUN ; Shanshan ZHANG ; Mengfan PENG ; Wenwen YUE
Chinese Journal of Applied Clinical Pediatrics 2023;38(8):591-594
Objective:To investigate the safety and efficacy of ultrasound-guided sclerotherapy combined with radiofrequency ablation on the complex lymphatic malformations (LM) in children.Methods:The clinical data of 21 children with complex LM treated with ultrasound-guided sclerotherapy combined with radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from June 2018 to October 2021 were retrospectively analyzed.Intraoperative and postoperative complications were recorded.Imaging examinations were performed at 1, 3, 6, 9, 12, 18, 24 months postoperatively to observe the recurrence, the volume of the lesions and their reduction rate were calculated, and the efficacy was analyzed. Friedman test was used to compare the lesion volume at different time points before and after surgery, and the reduction rate of lesion volume at 1 month postoperatively and other time points after surgery. Results:A total of 21 children were included in this study, among them, there were 12 males and 9 females, age range from 1 month to 5 years and 6 months, with a median age of 23 months.A total of 26 LM in 21 children were successfully treated, and no serious complications like organ damage occurred during and after surgery.One patient with abdominal LM had a postoperative infection, which was controlled by 3 weeks of catheter drainage.Four LM in 3 children recurred at 3 or 6 months after surgery, while all lesions were significantly narrowed down than those before surgery and they were cured after 1-3 sessions of continued sclerotherapy.There were significant differences in the lesion volumes before surgery and 1, 3, 6, 9, 12, 18 and 24 months postoperatively [222.26(159.57, 316.40) cm 3vs.43.06(22.74, 62.53) cm 3, 31.56(15.49, 45.94) cm 3, 25.21(9.63, 36.22) cm 3, 19.80(6.79, 28.81) cm 3, 12.80(3.93, 20.38) cm 3, 7.13(0, 11.34) cm 3, and 2.79(0, 4.93) cm 3; all P<0.05]. There were significant differences between the volume reduction rates at 1 month postoperatively and 3, 6, 9, 12, 18, and 24 months postoperatively [79.36(73.30, 87.81)% vs.85.40(81.09, 91.61)%, 88.85(84.70, 93.61)%, 91.67(87.87, 95.05)%, 94.15(94.47, 97.35)%, 97.11(95.02, 100.00)%, and 99.04(97.93, 100.00)%; all P<0.05]. Patients were followed up for 24 months, and all of them were cured. Conclusions:Ultrasound-guided sclerotherapy combined with radiofrequency ablation is a minimally invasive, safe and effective therapeutic strategy for children with complex LM.
7.Effect of NLRP3 Inflammasomes on Development of Diabetes Mellitus and Its Complications and Chinese Medicine Intervention via NLRP3: A Review
Jinxin MIAO ; Mengfan PENG ; Weihong REN ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(16):254-260
Diabetes mellitus (DM) is a metabolic disease mainly characterized by chronic hyperglycemia and has multiple etiologies. The complications of DM, such as coronary atherosclerosis, nephropathy, foot disease and cardiac dysfunction, have high morbidity, disability rate and mortality. DM and its complications have a long course of disease and are easy to relapse, which are difficult to be cured, seriously affecting people's life and health. NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome is an important component of inflammatory response and innate immune system. The inflammatory cascade induced by NLRP3 activation is involved in the occurrence and development of DM as well as its complications by releasing inflammatory factors, damaging endothelial cells and affecting metabolic stress. Therefore, as the core of the inflammatory response, NLRP3 may provide a new target for the treatment of DM and its complications. Traditional Chinese medicine plays a key role in the treatment of DM and its complications, and has a regulatory effect on NLRP3. Thus it has become a novel research strategy to prevent and treat DM and its complications via modulating NLRP3. However, at present, there are relatively scattered reports and a lack of systematic review on the role of traditional Chinese medicine in the treatment of DM and its complications from the perspective of NLRP3. As a result, this paper reviewed domestic and foreign literature in recent years and conducted the discussion from two aspects: the influence of NLRP3 on the occurrence and development of DM and its complications, and the progress of traditional Chinese medicine in intervening in DM and its complications through NLRP3. This paper provided reference for the research on the regulation of NLRP3 and a new direction for the treatment of DM and its complications.
8.Influence of Inflammation on Tumor and Intervention of Chinese Medicine: Based on "Inflammation-tumor Transformation"
Mengfan PENG ; Ming LI ; Jinxin MIAO ; Shuo TIAN ; Yuanxin ZHANG ; Chenhui LI ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(22):196-204
With high incidence and lethality rate and certain disability rate, tumor has become a major global public health threat. It has been verified that the occurrence and development of tumor are resulted from the synergy of environment, heredity, and gene mutation, involving the abnormal activation or inhibition of a variety of related pathways such as oxidative stress, inflammation, autophagy, and mesenchymal transition of cells. Among them, the excessive activation of inflammatory signaling pathway is one of the main mechanisms of carcinogenesis and tumor progression, which enhances the proliferation, chemoradiotherapy resistance, invasion, and metastasis of cancer cells. At the moment, the correlation between long-term chronic uncontrollable inflammation and "inflammation-cancer transformation" has been widely recognized. Therefore, it is of great significance for the prevention and treatment, diagnosis, and prognosis evaluation of tumor to clarify the role of inflammation in the incidence of tumor. Blockers or activators have been developed to target the corresponding inflammatory pathways. However, tumor is accompanied by the abnormality of multiple inflammatory pathways, especially the advanced tumor with metastasis of cancer cells, and thus the efficacy of single pathway-targeting agents is non-ideal. Chinese medicine, featuring multiple components and multiple targets, can remarkably control the inflammatory response, delay tumor progression, enhance the sensitivity of tumor cells to radiotherapy and chemotherapy, and reduce postoperative infection and the adverse reactions caused by radiotherapy and chemotherapy, thereby exerting the anti-cancer effect. Nevertheless, a few reports on the anti-tumor effect of Chinese medicine from the perspective of inflammation are available. Therefore, this paper mainly expounds the influence of inflammation on the occurrence and development of tumor and summarizes the research on the intervention of tumor by Chinese medicine through inflammatory pathway, which is expected to provide a new mindset for the prevention and treatment of tumor.
9.Macroscopic Clinical Medication Pattern of Traditional Chinese Medicine for Esophageal Cancer in Recent Ten Years Based on Data Mining
Hongyang DONG ; Mengfan PENG ; Yike AN ; Zhengwang ZHU ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(20):160-168
ObjectiveTo explore the macroscopic medication pattern of traditional Chinese medicine (TCM) in treating esophageal cancer (EC) and provide medication references for the clinical application of TCM in EC treatment. MethodRelevant literature on TCM treatment of EC was retrieved from three major Chinese databases: China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP. Information about Chinese herbal medicines was entered into Excel to establish a prescription database for EC. The data were standardized, summarized, and subjected to frequency analysis, association rules, and cluster analysis of medication in the prescriptions. Based on the TCM classification of EC syndromes, clinical indications corresponding to each syndrome were identified, and high-frequency drugs and drug pairs were analyzed correspondingly with syndromes. ResultA total of 136 prescriptions containing 240 Chinese herbal medicines were screened, with a cumulative frequency of 1 853 times. The top 5 frequently used Chinese herbal medicines were Glycyrrhizae Radix et Rhizoma, Poria, Atractylodis Macrocephalae Rhizoma, Astragali Radix, and Pinelliae Rhizoma. In terms of functions, the Chinese herbal medicines were mainly deficiency-tonifying, urination-promoting and dampness-draining, deficiency-tonifying, deficiency-tonifying, and phlegm-resolving and cough and dyspnea-relieving ones. The statistical analysis of flavor, property, and meridian tropism showed that Chinese herbal medicines were mainly bitter and sweet, warm, cold, and neutral, and acted on the spleen, lung, and stomach meridians. Association rule analysis yielded nine potential drug combinations, and cluster analysis of high-frequency drugs resulted in four combination categories. The four TCM syndromes for EC corresponded to respective clinical indications, treatment drugs, and drug pairs. ConclusionTonifying deficiency, reinforcing healthy Qi, descending adverse Qi, resolving phlegm, activating blood, and resolving stasis are the basic principles of TCM treatment for EC, which are supplemented by clearing heat and dissipating mass while focusing on regulating and smoothing the qi movement. The drug combinations obtained from high-frequency drug and association rule analysis provide references for different TCM syndrome treatments of EC, offering valuable insights for clinical medication.
10.Characteristics of Menstruation-regulating Chinese Patent Medicines in 2020 Edition of Chinese Pharmacopoeia
Xiaoli KONG ; Mengfan PENG ; Xinxin ZHOU ; Chenhui LI ; Xiaoyan FANG ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(14):173-180
ObjectiveTo analyze the functions, formulae, dosage forms, and methods of administration of the menstruation-regulating Chinese patent medicines included in the 2020 edition of the Chinese Pharmacopoeia, so as to provide reference for rational clinical use. MethodThe relevant Chinese patent medicines were recorded one by one, and the efficacy, dosage forms, methods of administration, and contraindications were counted, classified, and summarized. Further, we analyzed the Chinese medicines used in these Chinese patent medicines, identified the high-frequency Chinese medicines for menstrual regulation, and analyzed their natures, tastes, meridian tropism, and functions, aiming to guide the clinical use. ResultA total of 142 Chinese patient medicines for menstrual disorders were included in this study. They were classified into 12 categories according to their efficacy, mainly for regulating menstruation and blood, tonifying, activating blood, and eliminating mass. The representative Chinese patent medicines were Bazhen Yimu pills, Shaofu Zhuyu pills, Lyujiao Buxue granules, and Guizhi Fuling pills, which are in line with the principles of moving Qi and blood and regulating liver and spleen. Menstruation-regulating Chinese patents medicines are mostly in pills and capsules and are mainly taken with yellow wine or ginger decoction. Pregnancy was the contraindication with the highest frequency, followed by menstruation and dietary precautions. The high-frequency Chinese medicines mainly had the functions of tonifying, activating blood, resolving stasis, and clearing heat, with the top three being Angelicae Sinensis Radix, Paeoniae Radix Alba, and Chuanxiong Rhizoma. These medicines mainly had warm nature, sweet, bitter, and pungent tastes, and tropism to liver and spleen meridians. ConclusionThe treatment of menstrual disorders should focus on nourishing and activating blood, regulating Qi, tonifying kidney, supporting spleen, nourishing liver, and harmonizing stomach. The appropriate dosage form should be selected according to the patient's specific conditions. The medicinal guide and the method of administration should be selected on the basis of syndrome differentiation with attention to the contraindications. In summary, the Chinese patient medicines for menstrual regulation should be chosen based on the patient’s syndrome under guidance of the theory of traditional Chinese medicine.