1.Meta-analysis of Shenling Baizhu Powder Combined with Western Medicine in Treating Ulcerative Colitis
Yi WEN ; Xiangtao WENG ; Yue HU ; Xinlin CHEN ; Fengbin LIU
Journal of Guangzhou University of Traditional Chinese Medicine 2017;34(2):274-281
Objective To make a Meta-analysis of the effectiveness and safety of Shenling Baizhu Powder (SBP) for the treatment of ulcerative colitis(UC),thus to provide evidence for the clinical treatment of ulcerative colitis.Methods Randomized controlled trials (RCTs) of SBP combined with western medicine vs western medicine in treating ulcerative colitis were included.The quality of RCTs was assessed by the Cochrane scale.A Meta-analysis was performed for the clinical efficacy,improvement of disease activity index (DAI) levels of the included trials.Results A total of 19 RCTs were included,involving 1498 cases.The results of Metaanalysis showed that compared with the western medicine group,the combined risk ratio(RR) of clinical efficacy in the SBP combined group was 1.55,95% confidence interval (CI) being (1.39,1.72).The subgroup analysis based on control medicine showed that the combined RR of combined use of sulfasalazine or mesalazine/Olsalazine was 1.46,1.59 [95%CI (1.19,1.77) vs 95%CI (1.40,1.80)].The subgroup analysis based on different treatment courses showed that the combined RR of 1-30 days,31-60 days,61-90 days was 1.42,1.69,1.47 [95%CI (1.18,1.70) vs 95%CI (1.44,1.97) vs 95%CI (1.15,1.88)] respectively.The differences were significant (P < 0.05).(2) The differences of the two groups on the improvement of DAI and inflammatory factors levels of interlekin-17(IL-17),IL-23,tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP) were statistically significant(P < 0.05).(3)The sensitivity analysis of the primary outcomes showed a higher homogeneity in the literatures and the funnel plot analysis showed no evidence of publication bias.Conclusion Compared with western medicine,SBP combined with western medicine has better clinical efficacy for the treatment of UC,and the combined use of mesalazine/Olsalazine medicated for 30-60 days is more effective on improving DAI and inflammatory factors levels.However,for the low quality of the included literatures and insufficient experimental design,the conclusion needs more evidence from large sample-size randomized double-blind controlled trials.
2.The Clinical Significance of Eosinophil in Urosepsis
Junwei HE ; Jiadong CAO ; Shusheng WANG ; Xiangtao WENG ; Chiming GU ; Yuan LI ; Shu GAN
The Journal of Practical Medicine 2017;33(9):1445-1448
Objective To discuss The Clinical Significance of Eosinophil (EOS) in urosepsis. Methods A total of 99 patients of urosepsis in Department of Urology,Guangdong Provincial TCM Hospital from Mar. 2013 to Jul. 2016 were selected as research objects by retrospective analysis. The patients were classified into groupEOS= 0 andgroup EOS > 0,group PCT(procalcitonin)≥ 2 ng/mL andgroup PCT < 2 ng/mL,the differences of PCT concentration and percentage of EOS in two groups were analyzed comparatively. 99 patients of urosepsiswere also compared the difference of the percentage of EOS with another group including 100 patients of urinary tract infection (UTI) without Sepsis. Results The percentage of EOS was significantly decreased in 86.9%(86/99)of patients of urosepsis. The paired student t test show the percentage of EOS in two days after treatment,four days after treatment, before hospital discharge were higher than that before the treatment, the difference wassignificant (P < 0.05). The Independent-Sample Test show that the PCTconcentration in EOS = 0 group were higher than EOS > 0 group,the percentage of EOS in PCT≥2 ng/mL groupwere lower than PCT<2 ng/mL group,difference were significant(P<0.05). And The Independent-Sample Testalso showed that the percentage of EOS of the Urosepsis group was definitely lower than the UTI group without Sepsis. Difference was statistically significant. Concusions The percentage of EOS could be applied to assess the severity of urosepsis, monitor the disease progression and evaluate the infection control. The cost was lower than PCT in therapeuticprocess ofurosepsis.
3.Efficacy and safety on upper ureteric lithotripsy by Shuo Tong ureteroscopy
Shusheng WANG ; Xiangtao WENG ; Junhong ZHOU ; Shu GAN ; Zhijian LIAO ; Yanquan TANG ; Chiming GU ; Qianming ZOU
Chinese Journal of Urology 2017;38(9):671-674
Objective To investigate the efficacy and safety of Shuo Tong ureteroscopy in the treatment of upper ureteric stones.Methods The data of 832 patients,who underwent Shuo Tong ureteroscopy combined with holmium laser for the treatment of upper ureteric stones were collected between July 2014 and February 2017.The patients accepted general anesthesia under lithotomy position.After dilating the ureter,a ureteral access sheath was inserted along the guide wire.Finally,stones were broken and clean up by Shuo Tong ureteroscope.According to the stone size,823 patients were divided into ≤2.0 cm group (n=112,13.6%),2.1-3.0 cm group (n =395,48.0%),3.1-4.0 cm group (n =257,31.2%),> 4.0 cm group (n =59,7.2%)The stone free rate(SFR) and post-operative complications were observed.Results Among 983 operations,663 cases accepted one-stage operations and 160 cases accepted second stage operations.the operative time and postoperative hospital stay were 23-145 min(mean 74.8 ± 35.3) and 1-5 days(mean 1.9 ±0.8),respectively.The SFR in the first day and one month after operation was 75.6% and 83.8%,respectively.The stone free rate in each group were 89.3%,82.5%,61.1%,52.5% at first day after operation respectively(P < 0.05).While,the SFR after one month were 95.5%,87.6%,72.0%,61.0% in each group,respectively(P < 0.05).Fever rate after operation was 11.1%,ureteral injury rate was 1.9%,severe hematuria rate was 0.6%,stone street formation rate was 1.2%,perirenal hematoma rate was 0.4%.All patients were improved after conventional treatment.Conclusion Shuo Tong ureteroscopy is a safe treatment with high stone free rate for upper ureteric stones.