BACKGROUND: Modern medicine has not completely clarified the pathogenesis of diabetic gastroparesis, and Weidong Kang may have certain efficacy.OBJECTIVE: To observe the clinical efficacy and safety of Weidong Kang on diabetic gastroparesis, and compare with the efficacy of Motilium.DESIGN: A case-controlled observation.SETTINGS: Department of Traditional Chinese Medicine, Affiliated Hospital of Chongqing Normal University; Chongqing Institute of Traditional Chinese Medicine.PARTICIPANTS: Sixty outpatients and inpatients with diabetic gastroparesis were selected from the Affiliated Hospital of Chongqing Normal University and Chongqing Institute of Traditional Chinese Medicine from April 2001 to December 2005. They were randomly divided into two groups: ① treatment group (n =30): 20 males and 10 females; 31-58 years of age, the disease courses ranged from 0.5 to 26 years; ② control group (n =30): 18 males and 12 females; 30-69 years of age, the disease courses ranged from 0.5 to 20 years. Informed contents were obtained from all the subjects.METHODS: In the treatment group, the patients were treated with oral Weidong Kang decoction, three times a day,30 mL per time; Weidong Kang decoction consisted of official magnolia bark, immature bitter orange, betel nut, rhubarb,Chinese thorowax root, largehead atractylodes rhizome, dendrobium stem, 100 mL/bottle, containing 100 mg crude drug,provided by the Department of Pharmacy, Chongqing Institute of Traditional Chinese Medicine). In the control group, the patients with treated with Motilium, three times a day, 10 mg per time. All the patients were treated for four weeks as a course. The scores of dyspeptic symptoms and the time of gastric semi-emptying of liquid (T/2) were observed, the efficacy, the score of quality of life (QOL) and safety were evaluated before and after treatment.MAIN OUTCOME MEASURES: Scores of dyspeptic symptoms; Time of gastric semi-emptying of liquid (T/2); Evaluation of efficacy; score of QOL; Safety.RESULTS: All the 60 patients with diabetic gastroparesis were involved in the analysis of results. ① Amelioration of dyspeptic symptoms: After treatment, the scores of dyspeptic symptoms an total score were all obviously lower than those before treatment in both groups (P ＜ 0.01), the scores of epigastric satiety, nausea and vomiting, decreased appetite and epigastric pain in the treatment group were all obviously lower than those in the control group (P ＜ 0.05-0.01). ② Clinical efficacy: The total effective rate in the treatment group was obviously higher than that in the control group [90.0% (27/30); 73.3% (22/30), P ＜ 0.05]. ③ Time of gastric semi-emptying of liquid (T/2): In the treatment group,it was obviously ameliorated after treatment as compared with that before treatment (P ＜ 0.01). ④ Amelioration of QOL by symptom frequency-36 health survey (SF-36): In the treatment group, the scores of general health, somatic pain,vigor and mental health after treatment were obviously higher than those before treatment (P ＜ 0.05). In the control group, the scores of general health and mental health after treatment were obviously higher than those before treatment (P ＜ 0.05). ⑤ Evaluation of safety: In the treatment, there were no obvious differences in the blood and urine routine examinations, liver function and kidney function before and after treatment (P ＞ 0.05).CONCLUSION: Weidong Kang is an effective and safe drug for alleviating dyspeptic symptoms in patients with diabetic gastroparesis.

OBJECTIVE: To investigate the risk factors of tinnitus and provide evidence for tinnitus prevention. METHOD: Retrospectively analyzed the audiograms and the risk factors of 462 tinnitus victims who never perceived hearing loss, find the relationship between every risk factor and tinnitus. RESULT: The rate of tinnitus victims with high frequency hearing loss was the 46.1%, with low frequency hearing loss was 15.8%, with single middle frequency notch was 11.04%, with an audiogram like upset-basin was 7.58%, with normal audiogram was 14.07%, with other type of audiograms was 5.41%. The age distribution in the high frequency hearing loss group was mainly between 30 and 40 years, in the upset-basin hearing loss group was mainly older than 50 years, and in the other groups, mainly between 20 and 30 years. In the high frequency hearing loss group, male to female ratio was 158/55, in the low frequency hearing loss group and single middle frequency notch group ,male to female ratio was 14/59 and 12/39 respectively. In another three groups, the male to female ratio was nearly 1. Risk factors for high frequency hearing loss group, low frequency hearing loss, single middle frequency notch group and in the upset-basin hearing loss group were noise, fatigue, long-time musical instrument contact and ageing respectively. CONCLUSION Among the tinnitus victims who never perceived hearing loss, 86% of them have hearing impairment in high frequency area, low frequency area or single middle frequency. The rate of high frequency hearing loss was 46.01%, the major risk factor was noise, most of victims were men. The rate of low frequency hearing loss was 15.8%, the major risk factor was fatigue and nervous, most of the victims were women. The rate of single middle frequency notch was 11.04%, the major risk factor was long-time musical instrument contact. The rate of upset-basin hearing loss was 7.58%, ageing was the major risk factor.
Adolescent ; Adult ; Age Factors ; Aged ; Audiometry, Pure-Tone ; Auditory Threshold ; Child ; Child, Preschool ; Female ; Hearing Loss ; complications ; Hearing Tests ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Tinnitus ; complications ; physiopathology ; Young Adult

The long-term efficacy and complications of implantable diaphragm pacer (IDP) in a child with cervical spinal cord injury (CSCI) in the Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center in September 2022 were retrospective analyzed.A male child had quadriplegia without an obvious cause at the age of 12 years, and he was then lived completely with the assistance of mechanical ventilation.At the age of 14 years, he could wean off the ventilator in unilateral diaphragmatic pacing mode.However, mechanical ventilation was re-given for months after 5 years due to pneumonia, and then the IDP was re-given with the self-felt decreased pacing effect.After hospitalization, the patient was examined with mild diaphragmatic atrophy, secondary flat chest, and mild scoliosis.After optimization of the transdiaphragmatic pacing threshold and rehabilitation, his respiratory function improved.IDP can be used in CSCI for long time, while flat chest and scoliosis that limited the expansion of the lungs should be considered.At the meantime, the increased abdominal spasm affected the abdominal compliance, leading to the decrease in the efficiency of the diaphragm.

Objective To evaluate the therapeutic efficacy and adverse reactions of raltitrexed plus oxaliplatin (RALOX project) and S1 in patients with advanced primary liver cancer.Methods Seventy-one patients with advanced primary liver cancer admitted to 6 cancer centers from July 2013 to July 2015 were divided into 2 groups according to the wishes of the patients and their families:RALOX group (34 patients) and S1 group (37 patients).The therapeutic efficacy such as objective remission rate (ORR),disease control rate (DCR),median overall survival (mOS),median progression free survival (mPFS),one year survival rate (SR),and adverse reactions in these patients were evaluated.Results Thirty-one patients could be evaluated in RALOX group,and 6 patients obtained partial response (PR),10 stable disease (SD) and 15 progressive disease (PD).Thirty-three patients could be evaluated in S1 group,and 3 patients obtained PR,8 patients SD and 22 PD.The ORR,DCR,and one year SR were 19.4％ vs.9.1％,51.6％ vs.33.3％,and 22.6％ vs.12.1％ respectively,and there were no statistically significant differences in the two groups (x2 =1.393,P =0.238;x2 =2.190,P =0.139;x2 =1.229,P =0.268).The mOS and mPFS were 7.2 months vs.6.1 months and 3.4 months vs.2.8 months,and there were statistically significant differences in the two groups (x2 =6.433,P =0.011;x2 =4.078,P =0.043).There was more serious peripheral nerve toxicity (29.0％ vs.3.0％,x2 =6.344,P =0.012) and lighter hand-foot syndrome (9.7％ vs.30.3％,x2 =4.201,P =0.040) in RALOX group than S1 group.But the incidences of other adverse effects were similar in the two groups.Condnsion RALOX project is safe and effective to the patients with advanced primary liver cancer.Compare with S1 project,RALOX project has better curative effects and the majority of adverse reactions are tolerable.The patients have good condition control and survival benefit.

Objective:To analyze the factors influencing dysphagia after an injury to the cervical spinal cord (CPCI) to provide a basis for clinical screening and intervention.Methods:A total of 110 CPCI patients with dysphagia were divided into a severe dysphagia group ( n=19), a mild dysphagia group ( n=35), and a control group ( n=56) according to their functional oral intake scale scores. Data on gender, age, level of injury, degree of damage, duration of injury, causes of injury, surgical mode, tracheotomy status, occurrence of pneumonia and pharynx swelling were collected. Univariate and multivariate logistic regressions were evaluated to identify factors affecting swallowing. Results:The regressions highlighted age, the severity of the spinal cord injury, tracheotomy status, and the occurrence of pneumonia and pharyngeal swelling during hospitalization as the best predictors of swallowing difficulties. Multifactoral logistic regression analysis revealed that undergoing tracheotomy and catching pneumonia during hospitalization were major risk factors for severe dysphagia.Conclusions:Tracheotomy and pneumonia during hospitalization are useful predictors of severe dysphagia after a cervical spinal cord injury.

ObjectiveTo investigate the neurological outcome of children with dance-associated spinal cord injury without radiographic abnormality (SCIWORA) and explore its related factors and predictive model. MethodsFrom July, 2012 to January, 2022, 75 children with dance-associated SCIWORA hospitalized in Beijing Bo'ai Hospital were divided into improved group (n = 14) and non-improved group (n = 61) according to the American Spinal Injury Association Impairment Scale (AIS) grade a year later, and the related factors were analyzed. ResultsAll patients were girls aged four to ten years. Most of them were complete spinal cord injuries (52/75, 69%). The time of injury to rehabilitation (OR = 0.926, P = 0.046, 95%CI 0.858 to 0.999), the existing tendon reflex (OR = 46.915，P = 0.012, 95%CI 2.333 to 943.616) and muscle tension (OR = 8.932，P = 0.044，95%CI 1.063~75.067) were correlated with the AIS grade improvement. The combination of time of injury to rehabilitation, tendon reflex and muscle tone existing may predict the improvement of AIS (AUC = 0.953, P < 0.001，95%CI 0.878 to 0.989), the sensitivity and specificity were 100% and 83.61%, respectively. ConclusionThe neurological outcome of children with dance-associated SCIWORA is poor. Rehabilitation training as soon as possible is beneficial to the neurological recovery. Tendon reflexe and muscle tone existing at admission are closely related to improvement of neurological outcome, which could be used as potential indicators.

Objective: To assess the effects of different nutritional support methods on postoperative recovery in patients with gastric cancer. Methods: 98 patients who received radical gastrectomy were divided into three groups: parenteral nutrition group (PN group) (n=36), early enteral nutrition group (EEN group) (n=33) and early oral feeding group (EON group) (n=29). Tolerance of enteral nutrition, postoperative recovery and economic indicators were compared. Results: The number of laparoscopic-assisted surgeries was 18, 17 and 25 in PN group, EEN group and EON group, respectively. There was no significant difference in sex, age and body mass index(BMI) among the three groups. Gastrointestinal function recovered slowly in 3 cases, including 2 cases in EEN group and 1 case in EON group. 1 case in EON group had abdominal hemorrhage. Median postoperative hospital stay in PN, EEN and EON group was 11.0, 11.0 and 8.0 days respectively, and significant reduction can be found in EON group(P<0.001). The complication rates were 30.5% (11 cases), 12.1% (4 cases), and 13.8% (4 cases), respectively, with no statistically significant difference(P=0.102). The median nutritional support costs for PN group, EEN group, and EON group were 4 543.3, 974.2, and 265.0 yuan, respectively. The median albumin consumption was 90.0, 40.0, and 0 g, respectively. The EON groups were significantly lower (P<0.001). The results of the laparoscopic assisted subgroup and the ones of whole group were consistent. Conclusion Compared with parenteral nutrition and early enteral nutrition, early oral feeding can reduce the amount of albumin consumption, decrease the cost of nutrition support and shorten the average hospital stay after surgey without increasing the incidence of complications.