Authors raised that staging based strategies and practice of integrative medicine (IM) by combining syndrome typing and disease identification, and choosing suitable measures in accordance with different persons and seasonal conditions after more than ten years' clinical practice and researches. Radical operation as prior (as evil eliminating) and strengthening vital qi in perioerative period are best strategy for promoting rapid rehabilitation of early stage prostate cancer patients. Strengthening body resistance to eliminate evil was used in treating advanced prostate cancer patients. For example, a comprehensive treatment program for hormone-dependent patients was combined with endocrinotherapy and Chinese herbs for synergisic efficacy-enhancing actions. In this way, these patients' quality of life (QOL) were improved and time to castration resistant prostate cancer (CRPC) was delayed, even some patients were clinically cured. There are lack of effective medicines and methods for CRPC patients. Greatly tonifying original qi is mainly used for improving their clinical symptoms and prolonging survivals. Practice has proved staging based strategies and practice of IM has favorable advantages in treating prostate cancer, especially showing prospect in prolonging survival and postponing progression of advanced prostate cancer patients. Besides, it also could provide beneficial considerations and inspiration for combination of syndrome typing and disease identification.
Disease Progression ; Humans ; Male ; Medicine, Chinese Traditional ; Neoplasm Staging ; Prostatic Neoplasms, Castration-Resistant ; diagnosis ; Quality of Life

Hepatic encephalopathy (HE) is a common serious complication of liver cirrhosis, with sudden onset, indicating a poor prognosis in patients with chronic liver disease. Minimal hepatic encephalopathy (MHE) is an early stage of HE with no apparent symptoms, but it shows abnormal results in neuropsychological and/or neurophysiological tests. MHE affects patients' quality of life, employability, driving ability, and has a high risk of developing overt hepatic encephalopathy (OHE). This article aims to explore various diagnostic methods, strengthen the routine work of clinicians in diagnosis and treatment, and develop an effective MHE screening protocol.
Hepatic Encephalopathy/diagnosis* ; Humans ; Liver Cirrhosis/diagnosis* ; Liver Diseases ; Mass Screening ; Neuropsychological Tests ; Psychometrics ; Quality of Life

Objective:To investigate the feasibility and safety of a new method of natural orifice transluminal endoscopic surgery(NOTES) -totally transtracheal endoscopic thyroidectomy(TTET) .Methods:Three miniature swines and 6 beagle dogs were underwent TTET.Under general anesthesia,special designed endotracheal tube with 2-channel was used and endoscope and instruments were inserted through the respective channel.Incision of tracheal anterior wall was accomplished and partial or subtotal thyroidectomy was performed.Finally,the defects in the trachea were sutured with ENDO STITCH instrument.Results:Partial thyroidectomy was successfully accomplished on 3 pigs and subtotal thyroidectomy was done on 6 dogs.No serious complications such as anoxia,asphyxia,airway obstruction and death occurred during the operation.Animals were sacrificed 2h after the procedure and incision of trachea was found to be closely sutured.There were no subcutaneous emphysema and haematoma formation.Conclusion:Preliminary experimental results showed the feasibility and safety of TTET.Transtracheal access maintains the integrity of cervical tissues and achieves an optimal cosmetic outcome.TTET may open up a new field of NOTES on thyroid surgery.

Abscess ; Anti-Bacterial Agents/therapeutic use* ; Cerebral Ventriculitis/drug therapy* ; Encephalitis/drug therapy* ; Humans ; Pneumonia/etiology*

OBJECTIVETo evaluate the discrepancy between pre- and post-transplant diagnosis of end-stage dilated cardiomyopathy, a pre-transplantation diagnosis was compared with the diagnosis made after macroscopic and microscopic examination of the explanted hearts in 40 cardiac transplant recipients who had undergone cardiac transplantation at our institute.

METHODSPre-operation echocardiograms were obtained in all patients and coronary angiogram was obtained in 9 patients who had significant risk factors for coronary heart disease (CHD). CHD was considered present when there was a 75% reduction in cross-sectional luminal area of >or= 1 major coronary artery. Idiopathic dilated cardiomyopathy (IDC) was diagnosed when ventricular dilation and global reduction in ventricular systolic function were present in the absence of any identifiable cause. IDC patients with an alcohol consumption of > 100 g/day during the last 12 months before the onset of congestive heart failure were classified as having alcoholic cardiomyopathy. The pathological diagnosis of arrhythmogenic right ventricular cardiomyopathy was formulated in the presence of gross/or histological evidence of regional or diffuse transmural fatty or fibrofatty infiltration of the right ventricular free wall.

RESULTSBefore transplantation, 45.0%, 17.5%, 17.5% and 7.5% of patients were classified as IDC, CHD, alcoholic cardiomyopathy and hypertrophic cardiomyopathy. Post-transplant CHD diagnosis was made in all patients with a pre-transplant diagnosis of CHD. Post-transplant CHD diagnosis was also established in 4 patients with a pre-transplant diagnosis of IDC, in 4 patients with presumptive alcoholic cardiomyopathy, in 1 patient with hypertensive cardiomyopathy and in 1 patient with a pre-transplant diagnosis of aortic valve disease. Post-transplant arrhythmogenic right ventricular cardiomyopathy diagnosis was made in 6 patients with a pre-transplant diagnosis of IDC or KaShan disease. Post-transplant giant cell myocarditis diagnosis was made in 1 patient with a pre-transplant diagnosis of IDC.

CONCLUSIONPost-transplant CHD diagnosis is significantly higher than that of pre-transplant (42.5% vs. 17.5%, P < 0.05). Part of these patients might benefit from bypass surgery or PCI. Therefore, "in-depth" search for a heart failure cause, especially the coronary angiography examination, should be conducted in all heart transplantation candidates due to heart failure, regardless of their clinical presentation.

Adolescent ; Adult ; Cardiomyopathy, Dilated ; diagnosis ; pathology ; surgery ; Heart Failure ; diagnosis ; pathology ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stroke Volume

OBJECTIVETo investigate the diagnosis and treatment of patients with Crohn disease (CD) complicated with gastrointestinal fistulae.

METHODSClinical data of sixty-two cases with CD complicated with gastrointestinal fistula e from 1978 to 2004 were analyzed.

RESULTSThese were 68 external fistulae in 6 2 patients including recurrent fistulae in 6 cases, internal fistulae in 8 cases . Twenty- seven fistulae were located in the terminal ileum and 21 fistulae wer e located in ileocolic anastomosis site. The main surgery included 14 ileocecal resections with primary anastomosis and 26 resections of original ileocolic anastomosis with fistula and re-anastomosis. The incidence of recurrence was lower (15.4% ) in patients with postoperative medication including sulfasalazine and immunomodulator than that (34.8% ) in patients without postoperative immunomodulator,but the recurrence time was longer [(40+/- 17) months] in patients with postoperative medication than that [(8+/- 3)months] in the patients without postoperative specific medication.

CONCLUSIONSMost CD fistulae are external fistulae,most of the external fistulae are treated by resection of the fistula and anastomosis. Specific medication including sulfasalazine,mesalamine and immunomodulators should be used to prevent postoperative complications and CD recurrence.

Adult ; Crohn Disease ; complications ; diagnosis ; surgery ; Female ; Humans ; Intestinal Fistula ; complications ; diagnosis ; surgery ; Male ; Middle Aged

OBJECTIVETo probe into the effect of electroacupuncture (EA) at Shuigou (GV 26) on mild and moderate shock.

METHODSWith 3-center randomized control study method, 276 cases were assigned to an EA plus medicine group and a medication group, 138 cases in each group. They were treated respectively with western medicine plus EA at Shuigou (GV 26), and simple western medicine. Their curative effects were observed after treatment for 6 hours.

RESULTSThe blood pressure was immediately increased in the EA plus medicine group and the increase of blood pressure was earlier than that in the medication group (P<0.001). The markedly effective rate of 52.9% in the EA plus medicine group was significantly higher than 18.1% in the medication group (P<0.001).

CONCLUSIONThe therapeutic effect of EA at Shuigou (GV 26) plus western medicine on mild and moderate shock is better than that of simple western medicine.

Acupuncture Points ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Shock ; therapy

OBJECTIVESTo evaluate the impairment of fenvalerate on reproductive and endocrine systems and clarify the mechanism of action.

METHODSDifferent doses of fenvalerate (0, 2, 4, 12, 60 mg/kg) were orally treated to the adult male SD rats for 15 days and 30 days, respectively. The levels of serum follicle stimulating hormone(FSH), luteinizing hormone (LH), testosterone(T) and testis homogenate T were determined by radioimmunoassay(RIA). Besides, the activity of testicular marked enzymes such as acid phosphatases(ACP) and gamma-glutamyl transpeptidase(gamma-GT) were examined, and sperm head counts were measured to explain the changes of daily sperm production(Spr).

RESULTSIn fifteen days, serum FSH levels markedly increased in rats exposed to fenvalerate of < or = 12 mg/kg groups(P < 0.01) and serum levels of LH increased in 12 mg/kg group(P < 0.01). In addition, T levels in testis homogenates decreased after treated with the doses of > or = 12 mg/kg groups compared with the control group(P < 0.01). In thirty days, serum contents of FSH were significantly elevated in the doses of > or = 12 mg/kg groups(P < 0.01) and homogenate levels of T were diminished in the low dose group(2.4 mg/kg) (P < 0.05). Activity of ACP increased in 12 mg/kg group after fifteen days(P < 0.05) and was restrained in the high dose group(60 mg/kg) in thirty days(P < 0.05), but the contents of gamma-GT were arrested with different doses dependently in the testis(P < 0.05). Fenvalerate caused dose-dependent reduction in sperm head counts and daily sperm production, which markedly reduced at the doses of > or = 12 mg/kg groups(P < 0.01).

CONCLUSIONSFenvalerate has obvious reproductive toxicity on male rats and can change their serum and testis homogenate levels of sex hormone or activity of testicular marked enzymes, which may be correlated with the impairment of Sertoli cell and spermatogenic epithelium.

Animals ; Endocrine System ; drug effects ; metabolism ; Follicle Stimulating Hormone ; blood ; Insecticides ; toxicity ; Luteinizing Hormone ; blood ; Male ; Nitriles ; Pyrethrins ; toxicity ; Rats ; Rats, Sprague-Dawley ; Reproduction ; drug effects ; Spermatozoa ; drug effects ; Testosterone ; blood

OBJECTIVETo summarize the clinical changing characters of the clinical markers after interferon treatment in chronic hepatitis B (CHB) and make out practical indexes to predict the effect.

METHODS150 CHB patients were randomly divided into two groups: therapeutic group (90) and control group (60) in the prospective controlled trial. The levels of endogenous interferon before treatment, interferon antibody at the end of the second month and fourth month after treatment, alanine aminotransferase (ALT) and HBV DNA in the serum were detected. Then the data was analysed to find out indexes for predicting the effect.

RESULTS(1) The clearance rate of HBeAg had no significant difference in age except for 20 - 30 and 30 - 40 (t > 2.331 2, P < 0.01). (2) It was more effective if ALT level was higher than 400 U/L before treatment and it decreased more than 50% two months after treatment. (3) The patients whose HBV DNA was negative (dot hybridization) or less than 10(6) copies/ml before treatment had higher rate of HBeAg clearance. (4) There was no effect on patients whose interferon antibody turned positive at the end of the second month. (5)A predictive method of comprehensive factors was made out, whose sensitivity, specificity, and accuracy were 80%, 100% and 90%, respectively.

CONCLUSIONThe clinical characters of these Chinese patients are different from those of the westerners and the effects of interferon have close relation to the levels of ALT, HBV DNA and interferon antibody.

Adjuvants, Immunologic ; administration & dosage ; therapeutic use ; Adolescent ; Adult ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; DNA, Viral ; blood ; Female ; Hepatitis B Antibodies ; blood ; Hepatitis B virus ; isolation & purification ; Hepatitis B, Chronic ; drug therapy ; physiopathology ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Male ; Prospective Studies