OBJECTIVETo evaluate the efficacy and safety of Yigan Fupi Decoction (YFD) in the treatment of irritable bowel syndrome with diarrhea (IBS-D) patients.

METHODSA randomized controlled clinical trail was carried out in patients with IBS-D. All patients were randomly assigned to the treatment group (58 cases, treated with YFD) and the control group (58 cases, treated with Pinaverium Bromide Tablet). The treatment course was 4 weeks for all patients. The total effective rate, the stool property and state, the quality of life (QOL), and TCM syndrome efficacy were assessed by IBS bowel symptom severity scale (IBS-BSS), IBS defecation state questionnaire (IBS-DSQ), IBS quality of life questionnaire (IBS-QOL), and traditional Chinese medicine pattern curative effect scoring system (TCM-PES) before and after treatment.

RESULTSThere was no statistical difference in the total effective rate between the two groups (82.76% vs. 77.59%, P > 0.05). The treatment group was superior in the total IBS-BSS integral to the control group (P < 0.05). The total effective rate of improving the stool property was better in the treatment group than in the control group (81.03% vs. 72.41%, P < 0.05). Besides, the number of days for emergent defecation among 10 days was less in the treatment group than in the control group (P < 0.05). The improvement of the total IBS-QOL integral and the total integral of TCM syndrome were better in the treatment group than in the control group (P < 0.01). The total effective rate of TCM-PES was better in the treatment group than in the control group (84.48% vs. 70.69%, P < 0.05).

CONCLUSIONYFD was effective in the treatment of IBS-D patients of Gan-qi invading Pi syndrome, and could effectively relieve bowel symptoms, improve the stool property and the defecation frequency, elevate their QOL, and attenuate Gan-qi invading Pi syndrome with favorable safety and compliance.

Adult ; Diarrhea ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Irritable Bowel Syndrome ; drug therapy ; Male ; Middle Aged ; Morpholines ; therapeutic use ; Quality of Life ; Treatment Outcome

Adolescent ; Branchial Region ; Fistula ; congenital ; Humans ; Male ; Neck

0.05), the leukopenia rates 78.13%(25/32)vs 50.00%(17/34)(P

Objective To analyze the mammographic features of invasive lobular carcinoma (ILC)compared to those of invasive ductal carcinoma (IDC).Methods Twenty cases with ILC and 95 cases with IDC were retrospectively evaluated by two breast radi-ologists according to the Breast Imaging Reporting and Data System (BI-RADS)lexicon.The mammographic findings were com-pared between ILC and IDC with the independent samples chi-square test or Fisher’s exact test,as appropriate.Results Mass was the most common finding in both ILCs and IDCs,but less frequent in ILCs (36.4% vs 63.9%,P =0.008).Mass in ILCs was more frequently lobular or irregular shape with spiculated margin.Architectural distortion and focal asymmetry were more frequent in ILCs than in IDCs,however,the differences were no significant.The frequency of calcifications was not significantly different between the two groups.The distributions of calcifications were more regional in ILCs,and more segmental or linear in IDCs (P =0.01).Conclu-sion ILCs are more usually shown as non-mass appearances on mammography.ILCs that appeared as mass are more frequently ir-regular in shape with spiculated margins.

Objective To explore the optimal b value in MR DWI for breast.Methods Forty patients with palpable masses of breasts underwent MR and DWI at b = 1000, 800 and 600 s/mm2 before surgery according prospective planning. Visual assessment, signal to noise ratio (SNR) of DWI and the ADC values of benign and malignant lesions were compared among three b values using one-way ANOVA test.The diagnostic value of ADC were analyzed by ROC curves.Results Of the 40 patients, there were 26 patients with malignant lesions and 14 patients with benign lesions verified by histopathology.36 patients with 42 lesions were examined by DWI, and detectabilities at three b values were alike.Most DWI at b = 1000, 800 and 600 s/mm2 were of high quality, and images of grade A were 75.0% (30/40), 77.5% (31/40) and 77.5% (31/40), respectively.Mean SNR at b = 1000, 800 and 600 s/mm2 were 63 ± 22,82 ± 27 and 96 ± 29 respectively.Compared with one another, there was statistically significant difference (P <0.01).Mean ADC of benign lesions at different b values were (1.44 ± 0.28) × 10-3, (1.50 ± 0.32) × 10-3 and (1.52±0.29) × 10-3 mm2/s respectively. Compared with one another, there was no statistically significant difference (P = 0.725).Mean ADC of malignant lesions were (1.00 ± 0.25) × 10-3, (0.98 ± 0.19) × 10-3 and (1.07 ± 0.22) × 10-3 mm2/s respectively.Compared with one another, there was also no statistically significant difference (P = 0.358).The area under the ROC curves at b = 1000,800 and 600 s/mm2 were 0.879,0.885 and 0.865 respectively.Threshold value to distinguish benign and malignant lesions were 1.295 × 10-3,1.435×10-3 and 1.335×10-3 mm2/s respectively.Sensitivity of diagnosing breast cancer were 80.0%, 92.0% and 84.0%, and specificity were all 90.0% . Positive predictive values were 95.2%, 95.8% and 95.5% at b = 1000, 800 and 600 s/mm2.Conclusion Combining SNR and the value of ADC in diagnosing benign and malignant breast lesions, the study indicated that b = 800 s/mm2 was the optimal b value in breast DWI.

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cerebral Cortex ; drug effects ; metabolism ; pathology ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide Synthase ; metabolism ; Nitroso Compounds ; therapeutic use ; Rats ; Rats, Wistar

The purpose of the study was to observe the effect of rapamycin (RAPA) on the differentiation and maturation of rat bone marrow-derived dendritic cells (BMDCs) in vitro. BMDCs from Wistar rats were cultured with granulocyte-macrophage colony-stimulating factor plus interleukin-4 in the presence or absence of RAPA (20 ng/mL), and stimulated with lipopolysaccharide (LPS) for 24 h before cells and supernatants were collected. Surface phenotype of BMDCs was flow-cytometrically detected to determine the expression of maturation markers, MHC class II and CD86. Supernatants were analyzed for the production of IL-12 and IFN-gamma cytokines by using ELISA. BMDCs were co-cultured with T cells from Lewis rats and mixed lymphocyte reaction was assessed by MTT method. The morphology of BMDCs stimulated with LPS remained immature after RAPA pretreatment. RAPA significantly decreased the CD86 expression, impaired the IL-12 and IFN-gamma production of BMDCs stimulated with LPS, and inhibited the proliferation of allogeneic T cells. In conclusion, RAPA can inhibit the maturation of BMDCs stimulated with LPS in terms of the morphology, surface phenotype, cytokine production, and ability of BMDCs to stimulate the proliferation of allogeneic T cells in vitro.

Objective To investigate the occurrence of nocturnal myocardial ischemia and its relationship with sleep-disordered breathing (apneas and oxygen desaturations) in patients with angina pectoris undergoing coronary angiography.Methods Eighty-two men and 14 women referred for consideration of coronary intervention were randomly selected. Observation by an overnight sleep monitor and Holter recording were performed to study sleep-disordered breathing (oxyhemoglobin desaturations≥4％ and apnea-hypopneas),heart rates, and ST-segment depressions (≥ 1mm, ≥1 min).Results Nocturnal ST-segment depressions occurred in 37 ％ of the patients. ST-segment depression within 2 min after an apnea-hypopnea or desaturation occurred in 17％ of the patients. This temporal association was seen in 21％ of the patients with nocturnal ST-segment depressions, more frequently in men (P＜0.05) and more frequently in those with severe disordered breathing (P＜0.05).Most of these ST-segment depressions were preceded by a series of breathing events: repeated apnea-hypopneas or desaturations or both in 73％ of the patients. Conclusions Episodes of nocturnal myocardial ischemia are common in patients with angina pectoris. A temporal relationship between sleep-disordered breathing and myocardial ischemia was present in some of our patients, and occurs more frequently in men and in those with severely disordered breathing. (J Geriatr Cardiol 2004;1(2):90-94.)

OBJECTIVETo introduce the framework of evidence-based practice with a case of castration-resistant prostate cancer (CRPC) as an example.

METHODSA clinical question was formulated according the clinical scenario. A systematic search was conducted for the published literature in the databases of PubMed, EMBASE, Cochrane Library, Clinical Trial Registries, and Web of Knowledge up to Dec 2014. The identified literature was reviewed for quality appraisal before the evidence was applied to clinical practice.

RESULTSThe treatment was effective and the patient achieved disease remission.

CONCLUSIONEvidence-based practice should be integrated with clinical scenario, current evidence, and patients' willingness, and follow a systematic framework.

Evidence-Based Medicine ; Humans ; Male ; Orchiectomy ; Prostatic Neoplasms, Castration-Resistant ; therapy

Female ; Humans ; Leukemia, Promyelocytic, Acute ; Pregnancy ; Tretinoin