2.Impact of surgical operation-related factors on long-term survival of patients with hepatocellular carcinoma after hepatectomy.
Wen-ping LÜ ; Jia-hong DONG ; Wen-zhi ZHANG ; Xiao-qiang HUANG ; Shu-guang WANG ; Ping BIE
Acta Academiae Medicinae Sinicae 2008;30(4):386-392
OBJECTIVETo evaluate the prognostic value of surgical operation-related factors in patients with hepatocellular carcinoma (HCC).
METHODSThe clinical data of 234 patients after hepatic resection (214 men and 20 women) were retrospectively studied. Univariate and multivariate COX regression analyses were performed for surgical operation-related prognostic factors including age, gender, intraoperative blood loss, iatrogenic tumour rupture, transfusion, operation duration, hepatectomy extent, Pringle manoeuvre, with or without devarscularization, and complications (e.g. postoperative ascites, biliary leakage, incision infection, and pleural effusion). Kaplan-Meier and log-rank tests were used to compare survival rates. Kendall's tau bivariate analyses were used to examine the correlations of these surgical operation-related factors.
RESULTSUnivariate COX regression analysis revealed that iatrogenic blood loss (chi2 = 19.721, P < 0.001), transfusion (chi2 = 7.769, P = 0.005), tumour rupture (chi2 = 6.401, P = 0.011), operation duration (chi2 = 4.793, P = 0.029), and postoperative ascites (chi2 = 4.452, P = 0.035) were statistically significant predictors in patients with HCC after hepatic resection. Multivariate COX regression analysis revealed that pathological factors, such as blood loss (RR: 2.138, 95% CI: 1.556-2.939), tumour rupture (RR: 2.260, 95% CI: 1.182-4.321), and postoperative ascites (RR: 1.648, 95% CI: 1.088-2.469), independently influenced the HCC prognosis. Blood loss correlated with transfusion (Kendall's tau = 0.416, P < 0.001). There was no correlation between hepatectomy extent and blood loss (Kendall's tau = 0.057, P = 0.383), while transfusion closely correlated with the hepatectomy extent (Kendall's tau = 0.185, P = 0.004). The postoperative ascites closely correlated with Child classification (Kendall's tau = 0.151, P = 0.024).
CONCLUSIONSThe long-term survival of patients with HCC after hepatectomy may be improved by avoiding blood loss and iatrogenic tumour rupture. The indications of blood transfusion may not be strictly obeyed in some severe cases. Child class B and C cirrhotic patients may experience postoperative ascites and a worse prognosis, and therefore may be candidates for liver transplantation.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; mortality ; pathology ; surgery ; Child ; Female ; Hepatectomy ; adverse effects ; Humans ; Intraoperative Complications ; Liver Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult
3.Experiment study of tongfu huoxue decoction in the treatment of intracelebral hemorrhage.
Hua LIU ; Guo-Ping ZHANG ; Xiao-Dong BIE ; Hai-Tong WAN ; Shou-Yan FAN ; Yue-Guang DU
China Journal of Chinese Materia Medica 2006;31(6):507-509
OBJECTIVETo investigate the effects of Tongfu Huoxue decoction on experimental intracelebral hemorrhage and the associated machenisms.
METHODThe cerebral hemorrhage model in rats was induced by local injection of type VII collagenase and they were randomly divided into four groups. The treated groups were treated with Naoxuekang and Tongfu Huoxue decoction. The control groups were only treated with water. The changes of neurological defect were observed. The content of brain water, MDA, NO and the activity of SOD were measured.
RESULTThe cerebral hemorrhage rats showed hemiplegia, and the hemorrhage brains showed celebral edema, higher quotient of brain and content of brain water, suggesting the hemorrhage model was established successfully. After the treatment of Tongfu Huoxue decoction, the hemorrhage rats showed smaller hemorrhage volume, the brain tissue from the hemorrhage rats had lower MDA content and the quotient of brain, and also had higher activity of SOD and content of NO.
CONCLUSIONTongfu Huoxue decoction has treatment effects on cerebral hemorrhage.
Animals ; Arctium ; chemistry ; Brain ; metabolism ; pathology ; Cerebral Hemorrhage ; chemically induced ; drug therapy ; metabolism ; pathology ; Collagenases ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; therapeutic use ; Fallopia japonica ; chemistry ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism ; Phytotherapy ; Plants, Medicinal ; chemistry ; Prunus ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism
4.Treating ischemic stroke patients of deficiency of qi and yin syndrome and static blood obstructing collaterals syndrome by Yangyin Yiqi Huoxue Recipe: a clinical study of therapeutic effect.
Hai-Tong WAN ; Xiao-Dong BIE ; Zheng YAO ; Bin XU ; Hua LIU ; Jie-Hong YANG ; Yu- Van ZHANG ; Yu HE ; Hui-Fen ZHOU
Chinese Journal of Integrated Traditional and Western Medicine 2015;35(3):281-286
OBJECTIVETo observe the clinical effect of Yangyin Yiqi Huoxue Recipe (YYHR, the basic recipe of Yangyin Tongnao Granule) in treatment of ischemic stroke patients of deficiency of qi and yin syndrome (DQYS) and static blood obstructing collaterals syndrome (SBOCS).
METHODSTotally 312 patients were assigned to the control group (86 cases) and the treatment group (226 cases) using strati- fied randomized allocation method. Patients in the treatment group were treated with modified YYHR, while those in the control group took Xueshuan Xinmaining. The treatment course was 4 weeks for all. Constituent ratios of the acute stage and the recovery stage of DQYS and SBOCS and their complicated syndromes were observed in the two groups. Changes of the clinical curative effect, clinical symptoms integral, whole blood viscosity ratio, plasma viscosity ratio, hematocrit, erythrocyte sedimentation rate (ESR), total cho- lesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were detected in the two groups before and after treatment.
RESULTSThere was statistical difference in constituent ratios of the acute stage and the recovery stage of DQYS SBOCS and its complicated syndromes between the two groups (P < 0.01). DQYS and SBOCS was basic syndrome types of the two groups. The cured and markedly effective rate was 71.24%(161/226) in the treatment group and 43.02% (37/86) in the control group. The total effective rate was 91.15% (206/226) in the treatment group, higher than that of the control group (76.74%, 66/86) with statistical difference (P < 0.01). There was statistical difference in the clinical symptoms integral, whole blood viscosity ratio, plasma viscosity ratio, hematocrit, ESR, TC, TG,HDL-C, and LDL-C (P < 0.05, P < 0.01).
CONCLUSIONSSymptoms of ischemic stroke patients could be improved by modified YYHR. Indices such as the whole blood viscosity, plasma viscosity ratio, hematocrit, ESR, abnormal metabolism of blood lipids were also significantly improved. Pathological changes of blood stasis induced by qi-yin deficiency exist in ischemic stroke patients, and DQYS and SBOCS were basic syndrome types.
Aged ; Biomedical Research ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hematocrit ; Humans ; Male ; Middle Aged ; Qi ; Stroke ; drug therapy ; Triglycerides ; blood ; Yin Deficiency ; therapy
5.Clinical study on Zhuyu Tongfu serial recipe combined with acupuncture and massotherapy in treating hypertensive cerebral hemorrhage.
Hua LIU ; Guo-ping ZHANG ; Shui-jiang SONG ; Mei-ping DING ; Jun-fu ZHOU ; Xiao-dong BIE ; Jian-ren LIU ; Yun ZHANG ; Zhuo-hua LI ; Hai-feng GAO ; Guang-guo LIU ; Lai-ting FEI
Chinese journal of integrative medicine 2005;11(3):167-172
OBJECTIVETo observe the clinical efficacy and mechanism of Zhuyu Tongfu (ZYTF) Serial Recipe combined with acupuncture and massotherapy in treating hypertensive cerebral hemorrhage (HCH).
METHODSOne hundred and eighteen patients with hypertensive cerebral hemorrhage, on the basis of conventional Western medicine treatment, were randomly divided into ZYTF combined with acupuncture and massotherapy group (treated group) and simple Western medicine group (control group); the clinical efficacy, neurofunction deficit scoring (NDS) alterations and hematoma absorption rate of both groups were observed, and also the plasma superoxide dismutase (SOD) activity, plasma lipid peroxidase (LPO) content, erythrocyte glutathion peroxidase (GSH-Px) activity, hematocrit (Ht) and the whole blood viscosity (Va) change were also observed.
RESULTSIn the treated group, the clinical efficacy, NDS improvement and hematoma absorption rate were superior to that of the control group; comparison between the two groups after treatment showed that plasma SOD activity and GSH-Px activity got more elevated and plasma LPO content, Ht and Va more lowered in the the treated group than those in the control group.
CONCLUSIONZYTF combined with acupuncture and massotherapy has better effect, its therapeutic mechanism was possibly correlated to the elevation of plasma SOD activity, GSH-Px activity and lowering of plasma LPO content, Ht and Va.
Acupuncture Therapy ; methods ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Intracranial Hemorrhage, Hypertensive ; therapy ; Male ; Massage ; methods ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Treatment Outcome
6.Efficacy of Yangyin Yiqi Huoxue Granule () in Treatment of Ischemic Stroke Patients with Qi-Yin Deficiency and Blood Stasis Syndrome: A Randomized, Double-Blind, Multicenter, Phase-2 Clinical Trial.
Yu WANG ; Jie-Hong YANG ; Hai-Tong WAN ; Yu HE ; Bin XU ; Chang-Shan AI ; Hui-Fen ZHOU ; Li YU ; Hao-Fang WAN ; Xiao-Dong BIE
Chinese journal of integrative medicine 2021;27(11):811-818
OBJECTIVE:
To evaluate the efficacy and safety of Yangyin Yiqi Huoxue Granule (, YYHG) in the treatment of ischemic stroke (IS) patients with qi-yin deficiency and blood stasis syndrome (QYDBSS), and to explore its effective dosage.
METHODS:
The total of 288 patients were randomly assigned to the YYHG high-dose, YYHG low-dose, positive control (administered Xiaoshuantong Granule, XSTG, ), or placebo control (administered inert granule) groups (72 cases per group) by software-drived competitive block randomization. The trial was conducted for a 28-day period, with a 180-day follow-up period. The primary outcome was the comprehensive curative evaluation, and secondary outcomes were the National Institute of Health Stroke Scale (NIHSS) score, Barthel activities of daily living (ADL) index score, the quality of life index (QLI) score, and the Chinese medicine syndrome (CMS) score. All analyses were done on an intention-to-treat basis. The clinical safety was also assessed.
RESULTS:
The total of 288 participants were recruited between June 1, 2008 and September 30, 2009, and 287 patients received intervention; the treatment groups were well balanced at baseline. The comprehensive cure rates of YYHG high-dose, low-dose, positive and placebo control groups were 63.38%, 31.94%, 36.11% and 6.14%, respectively; there was a statistical difference between the two groups (P<0.01), while the high-dose YYHG treatment group was significantly higher than the other 3 groups (P<0.01). The improvement of NIHSS, ADL, QLI and CMS scores of the YYHG high-dose and low-dose groups was significantly better than that of the positive control group and the placebo control group (P<0.05). In terms of improving the classification of the NIHSS scale and the assessment of the ADL scale, the YYHG high-dose group was significantly better than the other three groups (P<0.05), and the YYHG low-dose group was better than the placebo control group (P<0.01). At the same time, except for the QLI score, the high-dose group was better than the low-dose group (P<0.05). In terms of safety, adverse reactions after YYHG treatment were generally mild (3.78%), and no serious adverse reactions have been reported.
CONCLUSION
YYHG is safe and effective in the treatment of IS patients with QYDBSS.
Activities of Daily Living
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Brain Ischemia/drug therapy*
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Humans
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Ischemic Stroke
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Qi
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Quality of Life
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Stroke/drug therapy*
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Yin Deficiency