ObjectiveTo observe the effect of modified Zuoguiwan combined with perindopril tert-butylamine tablets on early diabetic kidney disease （DKD） of Qi-Yin deficiency with blood stasis syndrome. MethodA total of 77 patients with early DKD of Qi-Yin deficiency with blood stasis syndrome， who were treated in the Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from september 2020 to november 2021， were randomized into the control group （38 cases） and observation group （39 cases）. The control group received basic treatment and perindopril tert-butylamine tablets， and the observation group was treated with modified Zuoguiwan and perindopril tert-butylamine tablets in addition to the basic treatment. The treatment lasted 3 months for both groups. The symptom scores， blood glucose ［fasting blood glucose （FBG）， 2 h postprandial blood glucose （2 h PBG）， glycosylated hemoglobin （HbA1c）， time in range （TIR）］， serum creatinine （SCr）， urea， estimated glomerular filtration rate （eGFR）， cystatin-C （Cys-C）， serum beta 2-microglobulin （Sβ₂-MB）， and urinary microproteins ［24 h urinary microalbumin （24 h UmAlb）， 24 h micrototal protein （24 h MTP）， urine beta 2-microglobulin （Uβ₂-MB）］ were observed in two groups. ResultThe two groups showed no significant difference in the various indexes before treatment. After treatment， the total effective rate of the control group was 84.2% （32/38）， as compared with the 94.9% （37/39） in the observation group （Z=6.03， P<0.05）. After treatment， the symptom scores were lower than those before treatment in both groups （P<0.01） and lower in the observation group than in the control group （P<0.01）. TIR level was higher （P<0.05） and levels of FBG， 2 h PBG， and HbA1c （P<0.01） were lower than those before treatment in both groups. After treatment， the TIR level in the observation group was significantly increased as compared with that in the control group （P<0.01）. After treatment， the level of Cys-C was lower than that before treatment in both group （P<0.01） and lower in the observation group than in control group （P<0.01）. The level of Sβ₂-MB in both the observation group （P<0.05） and control group decreased as compared with that before treatment. The 24 h UmAlb and Uβ₂-MB of two groups were decreased after treatment as compared with those before treatment （P<0.05）. Moreover， 24 h MTP in observation group （P<0.05） was lower than that before treatment. After treatment， the levels of 24 h UmAlb， 24 h MTP and Uβ₂-MB in observation group were lower than those in control group （P<0.01）， and levels of SCr and eGFR in observation group did not change significantly as compared with those in the control group. ConclusionModified Zuoguiwan combined with perindopril tert-butylamine tablets can reduce blood glucose fluctuations and urinary albumin excretion in early DKD patients of Qi-Yin deficiency with blood stasis syndrome. The efficacy is better than that of basic western medicine.

Patients with coronary heart disease have recurrent cardiovascular events after systemic treatment is often one of the leading factors increasing the death and hospitalization rates, thereby adding to the economic burden of society. According to foreign and domestic reports, poor compliance of cardiac rehabilitation in patients with coronary heart disease is a common problem at present. Therefore, in the rehabilitation of patients with coronary heart disease, Improving cardiac rehabilitation compliance is important in regaining health and cost saving during coronary heart disease recovery treatment. This study summarized the status and influence factors of cardiac rehabilitation compliance among foreign and domestic coronary heart disease patients and the interventions recommended for improving cardiac rehabilitation compliance.

OBJECTIVETo compare the effect of acupoint catgut embedding and western medication for treatment of non-alcoholic steatohepatitis (NASH).

METHODSSixty cases were randomly divided into a catgut embedding group and a western medicine group, 30 cases in each group. The catgut embedding group was treated with acupoint catgut embedding at Geshu (BL 17), Ganshu (BL 18), Zhongwan (CV 12), Qihai (CV 6), Zusanli (ST 36), Yanglingquan (GB 34), Fenglong (ST 40); the western medicine group was treated with oral administration of Tiopronin till the patients recovered normal liver function, then changed to take Xuezhikang capsule. Four weeks for a course of treatment, two groups were treated with two courses continuously. Then clinical symptoms, and levels of body mass index (BMI), obesity degree, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (gamma-GT), total cholesterol (TC), triglyceride (TG) and CT ratio of liver and spleen before and after treatment were compared between two groups.

RESULTSBMI, obesity degree and the levels of ALT, AST, gamma-GT, TC, TG in the serum decreased more significantly in two groups after treatment (all P<0.05), and there were significant differences between two groups (all P<0.05), the catgut embedding group decreased more significantly. CT ratio of liver and spleen was improved after treatment compared with that before treatment in two groups (both P<0.05), and the improvement of CT ratio of liver and spleen in the catgut embedding group was greater than that in the western medicine group (P<0.05). The total effective rate of 90.0% (27/30) in the catgut embedding group was superior to that of 76.7% (23/30) in the western medicine group, and the total efficiency of catgut embedding group was more effective than that in the western medicine group (P<0.05).

CONCLUSIONAcupoint catgut embedding is an effective method for the treatment of non-alcoholic steatohepatitis and this therapy is superior to oral administration of Tiopronin and Xuezhikang capsule.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Alanine Transaminase ; metabolism ; Aspartate Aminotransferases ; metabolism ; Catgut ; Fatty Liver ; enzymology ; therapy ; Female ; Humans ; Liver ; enzymology ; Male ; Middle Aged ; Prostheses and Implants ; Young Adult ; gamma-Glutamyltransferase ; metabolism

OBJECTIVETo analyze the clinical effectiveness of Shenling Fuzheng Capsule (SFC) and Qingdu Capsule (QC) in treating HIV/AIDS patients.

METHODSTotally 220 patients with complete clinical data, who received consecutive treatment for 6 months were selected from the database. They were assigned to two groups whether they would rather receive antiretroviral drugs, the Chinese medicine (CM) treatment group and the integrative medicine (IM) group. The 129 patients in the CM group were treated with SFC or QC, while the 91 patients in the IM group were treated with SFC or QC combined highly active antiretroviral agents. Total score and single score of clinical symptoms and signs, Karnofsky Performance Status (KPS), and changes of body weight before treatment, 3 and 6 months after treatment were compared. CD4+ cell counts were compared between before treatment and 6 months after treatment.

RESULTSThe total score of clinical symptoms and signs were lower at 3 and 6 months of treatment than before treatment respectively (P < 0.01). The single score of clinical symptoms and signs such as cough, weakness, shortness of breath, vomit, spontaneous perspiration, hair loss,and chest pain were also lowered at 3 and 6 months of treatment (P < 0.05, P < 0.01), and the KPS increased (P < 0.05). The body weight increased (P < 0.05) and CD4 cell counts decreased (P < 0.05) in the CM group. There was no statistical difference in body weight or CD4 cell counts in the IM group between before and after treatment.

CONCLUSIONSFC and QC could improve clinical symptoms and signs of HIV/ AIDS patients, but failed to deter the decrease of CD4+ cell counts.

Acquired Immunodeficiency Syndrome ; drug therapy ; Adolescent ; Adult ; Aged ; Anti-Retroviral Agents ; therapeutic use ; CD4 Lymphocyte Count ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Young Adult

Objective:To observe the protective effect of Huangqi Guizhi Wuwutang combined with Shengmaiyin on the heart function in patients with diabetic cardiomyopathy and explore its anti-myocardial fibrosis and anti-inflammatory effects. Method:The 96 patients were randomly divided into observation group （48 cases） and control group （48 cases）. Both groups were given comprehensive measures to control blood sugar， blood lipids， blood pressure and heart failure. Patients in control group took Tongmai Jiangtang capsule， 3 granules/time， 3 times/day. Patients in observation group took Huangqi Guizhi Wuwutang combined with modified Shengmaiyin， 1 dose/day. The treatment courses were three months in both groups. Left ventricular ejection fraction （LVEF）， early diastolic peak velocity E peak/late diastolic peak velocity A peak （E/A）， left ventricular end diastolic diameter （LVEDd） and cardiac output per stroke （SV） through echocardiography were recorded before and after therapy. Cardiac troponin-I （cTn I）， troponin T （cTn-T）， creatine kinase isoenzyme -MB （CK-MB）， lactate dehydrogenase （LDH）， transforming growth factor-β₁ （TGF-β₁） before and after treatment ， matrix metalloproteinase-2 （MMP-2）， insulin-like growth factor-1 （IGF-1）， interleukin-6 （IL-6）， IL-1， tumor necrosis factor-α （TNF-α）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， soluble ST2 （sST2） and galectin-3 （Gal-3） levels were detected. Symptom of cardiac insufficiency and traditional Chinese medicine （TCM） syndrome score were evaluated before and after treatment. Result:The LVEF and E/A data in observation group were higher than those in control group （P<0.01）. The levels of cTn-I， cTn-T， LDH and CK-MB in the observation group were lower than those in the control group （P<0.01）. After treatment， the levels of TGF-β₁， MMP-2， IGF-1， IL-6， IL-1， TNF-α， NT-proBNP， sST2 and Gal-3 in the observation group decreased and were lower than those in the control group （P<0.01）. The clinical efficacy of the observation group was better than that of the control group （Z=1.974，P<0.05）. Conclusion:On the basis of conventional intervention of western medicine， Huangqi Guizhi Wuwutang combined with modified Shengmaiyin has anti-inflammatory and anti-myocardial fibrosis effects， with inhibitory effect on myocardial remodeling， and can reduce myocardial tissue damage to improve ventricular diastolic function and protect heart function. With such high clinical efficacy， it is worthy of clinical use.

Adult ; Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Fluconazole ; administration & dosage ; therapeutic use ; Glucocorticoids ; adverse effects ; Hepatitis B, Chronic ; complications ; Humans ; Male ; Pulmonary Aspergillosis ; complications ; diagnosis ; drug therapy ; Tomography, X-Ray Computed

ObjectiveTo evaluate the clinical efficacy and safety of traditional Chinese medicine （TCM） suppository combined with Yishen Tongluo Qingkang decoction in the treatment of immune infertility. MethodA total of 116 patients meeting the inclusion criteria of this study were randomly divided into an observation group （58 cases） and a control group （58 cases）. The observation group was treated with TCM suppository combined with Yishen Tongluo Qingkang decoction，and the control group was treated with prednisone acetate tablets. Both groups were treated for 12 weeks and followed up six months after treatment. Semen samples of the patients were collected before and after treatment，and the pregnancy status of their spouses，negative conversion rate of seminal plasma anti-sperm antibody （AsAb），sperm concentration，motility，percentage of forward motile sperm，sperm acrosin activity， and incidence of adverse reactions were compared between the two groups. ResultA total of 104 patients completed the study，including 53 cases in the observation group and 51 cases in the control group. Before treatment，the baseline data of the two groups were balanced. After treatment，the total effective rate of the observation group was 92.45%，which was higher than that of the control group （76.47%）（P<0.05），and the negative conversion rate of AsAb in the observation group was higher than that in the control group，but the difference was not statistically significant. After treatment，the sperm motility， percentage of forward motile sperm， and sperm acrosin activity increased in the two groups（P<0.05），and the sperm concentration in the observation group increased （P<0.05）. There was no significant difference in sperm concentration in the control group. After treatment，the sperm concentration，motility，percentage of forward motile sperm， and acrosin activity in the observation group were better than those in the control group （P<0.05）. During the trial，the incidence of adverse reactions in the observation group was lower than that in the control group （P<0.05）. ConclusionTCM suppository combined with Yishen Tongluo Qingkang decoction can significantly increase the negative conversion rate of AsAb and improve the quality of semen in patients with immune infertility.

Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ² test were used to compare the short-term and long-term outcomes. The short-term outcomes included surgical related outcomes and operative complications, and the long-term outcomes included quality of life (pelvic floor functions and sexual functions), survival and recurrence. Pelvic floor function and sexual function were assessed with the International Consultation on Incontinence Quesonnaire Female Lower Urinary tract(ICIQ-FLUTS) and the Female Sexual Function Inventory (FSFI), respectively. Survival rates were estimated by Kaplan-Meier analysis. The survival curves were compared with Log-rank test. Cox regression analysis was used to evaluaterisk factors for prognosis. Results: (1)The short-term outcomes : There were significant difference in operative time([(257±69) vs(238±56)min], estimated blood loss[(358±314) vs(707±431)ml], anus exhausting time[(2.5±0.9) vs (2.9±0.8)d], preserved days of catheter[(15±7) vs(18±9)d], and post-operative length of stay[(19±16) vs (30±21)d] between the laparoscopic surgery group and the opensurgery group(P<0.05). There was no significant difference in lymph nodes yielded[(21±9) vs (21±11)], left parametrial width[(2.5±0.8) vs (2.7±0.7)cm], right parametrial width [(2.6±0.3) vs (2.7±0.2)cm], vaginal cuff length[(2.4±0.7) vs (2.2±0.7)cm] between the laparoscopic surgery group and the opensurgery group(P>0.05). The intra-operative complications occurred in 8.1%(87/1 071)in the laparoscopic surgery group and in 10.7%(85/792)in the open surgery group(P>0.05). However, the complications of vascular injury in the laparoscopic surgery group[2.6%(28/1 071)]was lower than that in the open surgery group[7.7%(61/792), P<0.001]. The laparoscopic surgery exhibited lower post- operative complication rate [33.8%(362/1 071)vs 40.2%(318/792), P<0.05] and poorer wound healing rate [0.7%(7/1 071)vs 4.0%(32/792), P<0.05]. (2)The long-term outcomes(Hierarchical analysis): The overall incontinence in ICIQ-FLUTS questionnaire in nerve-sparing laparoscopic group [28.4%(67/236)] was lower than that in the open surgery group [35.9%(71/198), P=0.004] . However, There was no significant difference in degree of incontinence between the two groups(P>0.05). The overall sexual dysfunction in FSFI questionnaire after 12 months of postoperative in the nerve-sparing laparoscopic group [47.0%(111/236)]was lower than that in the open surgery group [58.6%(116/198), P=0.001], and the six different dimension scores in the laparoscopic surgery group were higher than that in the open surgery group (P<0.05). The recurrence rate was 3.5%(35/1 007)in the laparoscopicsurgery group and 4.7%(35/740)in the open surgery group(P>0.05). The 5-year OS was 94.0% for the laparoscopic surgery group and 90.2% for the open surgery group(P>0.05), and the 5-year DFS was 93.9% for the laparoscopic surgery group and 89.1% for the open surgery group(P>0.05). (3) Prognostic fators: In univariate analysis, tumor dimension, clinical stage, deep stromal invasion, LVSI, and retroperitoneal lymph node metastasis signficantly affected 5-year OS and 5-year DFS(P<0.05); In multivariate analyses, LVSI, deep stromal invasion and LN metastasis were independent prognostic factors(P<0.05). Conclusions Laparoscopy can reduceestimated blood loss, accelerate postoperative recovery and improve the quality of life after surgery compared to laparotomy, and it ensures the same oncological results as open surgery. Laparoscopic approach is a safe and effective treatment for early-stage cervical cancer.

Non-small cell lung cancer is one of the cancers with the highest incidence and mortality rate in the world, and precise prognostic models can guide clinical treatment plans. With the continuous upgrading of computer technology, deep learning as a breakthrough technology of artificial intelligence has shown good performance and great potential in the application of non-small cell lung cancer prognosis model. The research on the application of deep learning in survival and recurrence prediction, efficacy prediction, distant metastasis prediction, and complication prediction of non-small cell lung cancer has made some progress, and it shows a trend of multi-omics and multi-modal joint, but there are still shortcomings, which should be further explored in the future to strengthen model verification and solve practical problems in clinical practice.

OBJECTIVE: To assess the effect and safety of Hydroxysafflor Yellow A for Injection (HSYAI) in treating patients with acute ischemic stroke (AIS) and blood stasis syndrome (BSS). METHODS: A multicenter, randomized, double-blind, multiple-dose, active-controlled phase II trial was conducted at 9 centers in China from July 2013 to September 2015. Patients with moderate or severe AIS and BSS were randomly assigned to low-, medium-, high-dose HSYAI groups (25, 50 and 70 mg/d HSYAI by intravenous infusion, respectively), and a control group (Dengzhan Xixin Injection (, DZXXI) 30 mL/d by intravenous infusion), for 14 consecutive days. The primary outcome was the Modified Rankin Scale (mRS) score ⩽1 at days 90 after treatment. The secondary outcomes included the National Institute of Health Stroke Scale (NIHSS) score ⩽1, Barthel Index (BI) score ⩾95, and BSS score reduced ⩾30% from baseline at days 14, 30, 60, and 90 after treatment. The safety outcomes included any adverse events during 90 days after treatment. RESULTS: Of the 266 patients included in the effectiveness analysis, 66, 67, 65 and 68 cases were in the low-, medium-, and high-dose HSYAI and control groups, respectively. The proportions of patients in the medium- and high-dose HSYAI groups with mRS score ⩽1 at days 90 after treatment were significantly larger than the control group (P<0.05). The incidences of favorable outcomes of NIHSS and BI at days 90 after treatment as well as satisfactory improvement of BSS at days 30 and 60 after treatment in the medium- and high-dose HSYAI groups were all significantly higher than the control group (P<0.05). No significant difference was reported among the 4 groups in any specific adverse events (P>0.05). CONCLUSIONS HSYAI was safe and well-tolerated at all doses for treating AIS patients with BSS. The medium (50 mg/d) or high dose (75 mg/d) might be the optimal dose for a phase III trial. (Registration No. ChiCTR-2000029608).