OBJECTIVE: To observe the therapeutic effect of governor vessel moxibustion combined with wenyang yiqi qiwei decoction on erectile dysfunction (ED) with spleen-kidney deficiency and to explore the possible mechanism. METHODS: A total of 130 ED patients with spleen-kidney deficiency were randomized into an observation group (65 cases, 2 cases dropped off) and a control group (65 cases, 3 cases dropped off). The control group was given wenyang yiqi qiwei decoction orally, one dose daily. On the basis of the treatment in the control group, governor vessel moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) in the observation group, 110 min a time, once a day. The treatment of 4 weeks was required in both groups. Before and after treatment, 5-question international index of erectile function (IIEF-5) score, erection quality scale (EQS) score, erectile hardness assessment (EHS) score, TCM syndrome score, serum testosterone (T) level and vascular endothelial function indexes (prostaglandin I2 [PGI2], endothelin-1 [ET-1] and nitric oxide [NO] levels) were observed respectively, and the clinical efficacy was evaluated in both groups. RESULTS: After treatment, the scores of IIEF-5, EQS, EHS and serum levels of T, PGI2, NO were increased compared before treatment (P<0.01), the TCM syndrome scores and serum ET-1 levels were decreased compared before treatment (P<0.01) in the two groups; the scores of IIEF-5, EQS, EHS and serum levels of T, PGI2, NO in the observation group were higher than those in the control group (P<0.01, P<0.05), the TCM syndrome score and serum ET-1 level were lower than those in the control group (P<0.01, P<0.05). The total effective rate was 88.9% (56/63) in the observation group, which was superior to 74.2% (46/62) in the control group (P<0.05). CONCLUSION Governor vessel moxibustion combined with wenyang yiqi qiwei decoction can improve the erectile function and increase the erection hardness and quality in ED patients with spleen-kidney deficiency, its mechanism may relate to improving serum T level and vascular endothelial function.
Humans ; Male ; Administration, Oral ; Drugs, Chinese Herbal/therapeutic use* ; Erectile Dysfunction/therapy* ; Kidney/pathology* ; Kidney Diseases/complications* ; Moxibustion ; Spleen/pathology* ; Splenic Diseases/complications* ; Testosterone/blood* ; Combined Modality Therapy

Histiocytoma, Benign Fibrous/surgery* ; Humans ; Splenectomy ; Splenic Diseases/pathology* ; Splenic Neoplasms/surgery*

The present situation of the clinical application of dog-days moxibustion (moxibustion applied in the three periods of the hot season) is summarized so as to provide the guide for the theoretic study and clinical application of dog-days moxibustion. The intervention time of dog-days moxibustion is on the 1st day of each of the three periods of the hot season. Simultaneously, the geographic factors are considered. The disorders of lung system are mostly dominant among the indications of dog-days moxibustion, complicated with spleen and stomach disorders as well as cold and deficiency syndromes/patterns. The acupoints are mainly selected from the front- points on the chest and the back- points on the back, in combination with the differentiation of diseases, symptoms/patterns and the disorder stages. The duration of treatment is ranged from 1 to 3 years. The clinical therapeutic effect is improved constantly along with the increase of treatment periods by years.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Lung Diseases ; Moxibustion ; Seasons ; Splenic Diseases ; Stomach Diseases

Epstein-Barr virus (EBV) infection can be presented with various clinical manifestations and different levels of severity when infected. Infectious mononucleosis, which is most commonly caused by EBV infection in children and adolescents, is a clinical syndrome characterized by fatigue, malaise, fever, sore throat, and generalized lymphadenopathy. But rarely, patients with infectious mononucleosis may present with gastrointestinal symptoms and complicated by gastritis, splenic infarction, and splenic rupture. We encountered a 16-year-old girl who presented with fever, fatigue, and epigastric pain. Splenic infarction and EBV-associated gastritis were diagnosed by using esophagogastroduodenoscopy and abdominal computed tomography. Endoscopy revealed a generalized hyperemic nodular lesion in the stomach, and the biopsy findings were chronic gastritis with erosion and positive in situ hybridization for EBV. As splenic infarction and acute gastritis are rare in infectious mononucleosis and are prone to be overlooked, we must consider these complications when an infectious mononucleosis patient presents with gastrointestinal symptom.
Adolescent ; Biopsy ; Child ; Endoscopy ; Endoscopy, Digestive System ; Epstein-Barr Virus Infections ; Fatigue ; Female ; Fever ; Gastritis* ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization ; Infectious Mononucleosis ; Lymphatic Diseases ; Pharyngitis ; Splenic Infarction* ; Splenic Rupture ; Stomach

Gastric remnant necrosis after a subtotal gastrectomy is an extremely uncommon complication due to the rich vascular supply of the stomach. Despite its rareness, it must be carefully addressed considering the significant mortality rate associated with this condition. Patients vulnerable to ischemic vascular disease in particular need closer attention and should be treated more cautiously. When gastric remnant necrosis is suspected, an urgent endoscopic examination must be performed. We report a case of gastric remnant necrosis following a subtotal gastrectomy and discuss possible risk factors associated with this complication.
Endoscopy ; Gastrectomy* ; Gastric Stump* ; Humans ; Ischemia ; Mortality ; Necrosis* ; Risk Factors ; Splenic Infarction* ; Stomach ; Vascular Diseases

OBJECTIVE: The purpose of this study was to asses the CT findings and clinical features differentiating malignant from benign focal splenic lesions. MATERIALS AND METHODS: Among 673 patients with splenectomy, we included 114 patients with pathologically confirmed focal splenic lesions (malignant = 66, benign = 48). Two radiologists retrospectively assessed CT findings including: size, number, solid component, margin, wall, calcification, contrast-enhancement, lymph node (LN) enlargement and possible malignancy. We assessed clinical features including age, sex, underlying malignancy, fever, and leukocytosis. Multivariate logistic regression analysis was performed to identify significant predictors of malignant lesion. We used receiver operating curve analysis for determination of diagnostic performance. RESULTS: Common findings of malignant lesions include enhanced, mainly solid, ill-defined margin, absence of splenomegaly, absence of the wall, absence of calcification, LN enlargement, and presence of underlying malignancy (p < 0.05). Among them, mainly solid features (odds ratio [OR], 39.098, p = 0.007), LN enlargement (OR, 6.326, p = 0.005), and presence of underlying malignancy (OR, 8.615, p = 0.001) were significant predictors of malignancy. The mean size of benign splenic lesions (5.8 ± 3.3 cm) was larger than that of malignant splenic lesions (4.0 ± 3.4 cm). Diagnostic performance of CT findings by two reviewers using receiver operating characteristic curve analysis for differentiation of malignant lesions was 0.856 and 0.893, respectively. CONCLUSION: Solid nature of the splenic mass on CT images, LN enlargement, and presence of underlying malignancy are significant predictors of malignant splenic lesion.
Equidae ; Fever ; Humans ; Leukocytosis ; Logistic Models ; Lymph Nodes ; Retrospective Studies ; ROC Curve ; Spleen ; Splenectomy ; Splenic Diseases ; Splenomegaly

PURPOSE: Because children with asplenia have an increased risk of fulminant infection associated with a high fatality, chemoprophylaxis, and vaccinations against encapsulated bacteria are recommended. However, there have been few reports of the burden of severe bacterial infection and the current status of chemoprophylaxis and immunization among children with asplenia in Korea. METHODS: We conducted a retrospective study including children with asplenia who were treated at our institute between January 1997 and December 2016. RESULTS: From a total of 213 children with asplenia, 114 (53.5%) had congenital asplenia and 58 (27.2%) had functional asplenia. The remaining 41 (19.3%) had acquired asplenia with the median age at splenectomy being 12.2 years (range, 5.0 to 16.9 years); the most common cause of splenectomy was hereditary spherocytosis (39.0%). The chemoprophylaxis rate was 16.4%. The immunization rates were 44.1% for pneumococcus, 53.0% for Haemophilus influenzae type B, and 10.7% for meningococcus. The incidence of invasive bacterial infection among children with asplenia was 0.28/100 person-year; a total of six episodes (2.8%) were observed in five patients with congenital asplenia and one patient with functional asplenia. The median age for these infections was 15 months (range, 4 to 68 months). Five of the six episodes were bacteremia, and the other was meningitis. The most common pathogen was Streptococcus pneumoniae (n=3), followed by H.influenzae (n=1). Three of the six patients (50.0%) died, all of whom had pneumococcal bacteremia. None of the six had chemoprophylaxis or proper vaccinations. CONCLUSIONS: Although there is an increased risk of a severe infection proper vaccinations and chemoprophylaxis are still lacking. Physicians should be encouraged to implement appropriate chemoprophylaxis and immunizations for patients with asplenia.
Bacteremia ; Bacteria ; Bacterial Infections* ; Chemoprevention ; Child* ; Haemophilus influenzae type b ; Humans ; Immunization ; Incidence ; Korea ; Meningitis ; Neisseria meningitidis ; Retrospective Studies* ; Splenectomy ; Splenic Diseases ; Streptococcus pneumoniae ; Vaccination

PURPOSE: Because children with asplenia have an increased risk of fulminant infection associated with a high fatality, chemoprophylaxis, and vaccinations against encapsulated bacteria are recommended. However, there have been few reports of the burden of severe bacterial infection and the current status of chemoprophylaxis and immunization among children with asplenia in Korea. METHODS: We conducted a retrospective study including children with asplenia who were treated at our institute between January 1997 and December 2016. RESULTS: From a total of 213 children with asplenia, 114 (53.5%) had congenital asplenia and 58 (27.2%) had functional asplenia. The remaining 41 (19.3%) had acquired asplenia with the median age at splenectomy being 12.2 years (range, 5.0 to 16.9 years); the most common cause of splenectomy was hereditary spherocytosis (39.0%). The chemoprophylaxis rate was 16.4%. The immunization rates were 44.1% for pneumococcus, 53.0% for Haemophilus influenzae type B, and 10.7% for meningococcus. The incidence of invasive bacterial infection among children with asplenia was 0.28/100 person-year; a total of six episodes (2.8%) were observed in five patients with congenital asplenia and one patient with functional asplenia. The median age for these infections was 15 months (range, 4 to 68 months). Five of the six episodes were bacteremia, and the other was meningitis. The most common pathogen was Streptococcus pneumoniae (n=3), followed by H.influenzae (n=1). Three of the six patients (50.0%) died, all of whom had pneumococcal bacteremia. None of the six had chemoprophylaxis or proper vaccinations. CONCLUSIONS: Although there is an increased risk of a severe infection proper vaccinations and chemoprophylaxis are still lacking. Physicians should be encouraged to implement appropriate chemoprophylaxis and immunizations for patients with asplenia.
Bacteremia ; Bacteria ; Bacterial Infections* ; Chemoprevention ; Child* ; Haemophilus influenzae type b ; Humans ; Immunization ; Incidence ; Korea ; Meningitis ; Neisseria meningitidis ; Retrospective Studies* ; Splenectomy ; Splenic Diseases ; Streptococcus pneumoniae ; Vaccination

Objective: To investigate the correlation between the syndrome types of traditional Chinese medicine (TCM) and clinical symptoms of benign prostatic hyperplasia (BPH) with chronic prostatitis (BPH-CP). METHODS: We selected 150 cases of BPH-CP in this study and divided them into 7 TCM syndrome types. Using univariate and multivariate logistic regression analyses, we studied the correlation of each TCM syndrome type with the age, disease course, prostate volume, postvoid residual urine volume (PVR), prostate-specific antigen (PSA) level, maximum urinary flow rate (Qmax), and International Prostate Symptoms Score (IPSS). RESULTS: Kidney-yin deficiency was correlated positively with the prostate volume but negatively with Qmax and IPSS; kidney-yang deficiency positively with the age and prostate volume but negatively with IPSS; the damp heat syndrome positively with the PSA level but negatively with the disease course, prostate volume and Qmax; the spleen-qi deficiency syndrome positively with the prostate volume but negatively with the disease course; liver-qi stagnation positively with the disease course but negatively with the age, prostate volume and PVR; the syndrome of qi stagnation and blood stasis positively with the disease course and IPSS but negatively with PVR; the syndrome of lung-heat and qi blockage positively with the age, Qmax and IPSS but negatively with the disease course. CONCLUSIONS The TCM syndrome types of BPH-CP are closely correlated to their clinical symptoms. The analysis of the clinical objective indexes of BPH-CP can provide some reliable evidence for accurate identification of the TCM syndrome type of the disease.
Age Factors ; Chronic Disease ; Disease Progression ; Humans ; Kidney Diseases ; diagnosis ; Liver Diseases ; diagnosis ; Male ; Medicine, Chinese Traditional ; Organ Size ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; classification ; diagnosis ; Prostatitis ; classification ; diagnosis ; Qi ; Regression Analysis ; Splenic Diseases ; diagnosis ; Symptom Assessment ; classification ; methods ; Urination ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

We present the case of a 27-year-old female who presented in hypovolemic shock due to splenic rupture without apparent cause. The patient underwent an open splenectomy followed by an uneventful recovery. Post-operatively the patient could recall no trauma, and exams for viral and neoplastic etiologies were unrevealing. Spontaneous splenic rupture is a rare condition requiring a high index of suspicion, and patients should be managed with prompt splenectomy.
Adult ; Female ; Humans ; Rare Diseases ; Rupture, Spontaneous ; Shock ; Spleen ; Splenectomy ; Splenic Rupture*