1.Real-World Study on the Clinical Efficacy of Different Medication Regimens of Wangbi Tablet (尪痹片) in the Treatment of Knee Osteoarthritis
Kuayue ZHANG ; Chao LI ; Zhuoyun WU ; Yawei DONG ; Zelu ZHENG ; Yuzhi LIU ; Jun ZHOU ; Jiaming LIN ; Yuefeng CHEN ; Baohong MI ; Weiheng CHEN
Journal of Traditional Chinese Medicine 2024;65(22):2316-2325
ObjectiveTo investigate the differences in clinical efficacy of different medication regimens of Wangbi Tablets (尪痹片) for knee osteoarthritis (KOA) in a real-world setting, providing a basis for rational clinical use of Wangbi Tablets. MethodsA prospective registry study was conducted, involving 2,999 KOA patients registered in 30 hospitals nationwide from January 26th, 2019, to December 17th, 2021. Based on the use of Wangbi Tablets during the observation period, patients were divided into a monotherapy group (1,507 cases) and a combination therapy group (1,492 cases), and the combination group can be further divided into Wangbi Tablets plus Chinese medicine (CM), Wangbi Tablets plus western medicine (WM), and Wangbi Tablets plus Chinese and western medicine (CM+WM) subgroups. The baseline data of patients in the monotherapy group and the combination group were compared, including age, gender, body weight, medication time, clinical stage, K-L grade, and others. Efficacy indicators included the Visual Analog Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and EuroQol five-dimensional (EQ-5D) health index, which were evaluated before and after 4-, 8- and 12-week treatment, and the difference before and after treatment was calculated after 4, 8 and 12 weeks of treatment. The difference between the baseline and 12 weeks of treatment of all the above indicators was used as the dependent variables, and gender, age, body mass index (BMI), course of disease, K-L grade, and clinical stage were used as independent variables, when multiple linear regression was taken to explore the influencing factors of the efficacy. At the same time, the occurrence of major symptoms (including morning stiffness, joint swelling, soreness of waist and knees, fear of wind, and fear of cold) was counted, and the disappearance of symptoms at each time point was counted after 4, 8, and 12 weeks of treatment. ResultsAt baseline, there were no statistically significant differences in gender and age distribution between the monotherapy and combination therapy groups (P>0.05); the proportion of patients in the acute stage and recovery stage was higher in the monotherapy group than in the combination therapy group, while the proportion in the remission stage was lower (P<0.05); the VAS score was higher in the monotherapy group, and the EQ-5D index was lower (P<0.01), with no statistically significant difference in total WOMAC score between the two groups (P>0.05). Compared to those measured before treatment and at previous timepoint, the VAS score and WOMAC total score significantly decreased in both groups, while EQ-5D value increased (P<0.05). The difference in VAS score between baseline and after 12-week treatment was higher in the monotherapy group than the combination group, while the differences in WOMAC total score and EQ-5D value between baseline and after 4-, 8- and 12-week treatment were higher in the combination group (P<0.05). Multiple linear regression showed that VAS score before treatment had greatest impact on pain improvement (P<0.01), and compared to Wangbi Tablets monotherapy, the combination of Wangbi tablets with WM or CM had larger associations with pain improvement (P<0.05); and Wangbi Tablets had better efficacy when the course of treatment was >28 days (P<0.01). Wangbi Tablets plus WM had a better effect on improving the overall function of the knee joint than Wangbi Tablets alone (P<0.01); and the efficacy of Wangbi Tablets with a course of treatment >28 days was better (P<0.05). The improvement of quality of life of patients in the attack and remission stages was more obvious than that in the recovery stage (P<0.01); Wangbi Tablets plus WM or CM had a better effect on improving quality of life than Wangbi Tablets alone (P<0.05). Before treatment, the proportion of patients with morning stiffness, soreness of waist and knees, fear of wind and chills in the monotherapy group was higher than that in the combination group (P<0.01). The proportion of main symptoms in both groups decreased after 4, 8 and 12 weeks of treatment (P<0.05). After 4 weeks of treatment, the disappearance rate of each main symptom in the combination group was higher than that in the monotherapy group, and after 12 weeks of treatment, the disappearance rate of fear of wind in the monotherapy group was higher than that in the combination group, while the disappearance rate of joint swelling and soreness of waist and knees was lower (P<0.05). ConclusionWangbi Tablets, whether used alone or in combination with other medications, is effective throughout the course of KOA, with greater benefits in improving joint function and quality of life during the acute and remission stages compared to the recovery stage. Combination therapy had a faster onset of effect, but began to converge with monotherapy after 8 weeks. The best efficacy was observed with the combination of Wangbi Tablets with WM, followed by combination with CM.
2.Real-world Study of Medication Characteristics and Clinical Efficacy of Tenghuang Jiangu Tablets in Treatment of Knee Osteoarthritis in Remission Stage
Zhihong FU ; Shuwen LI ; Ruihan LI ; Yan JIA ; Ruizheng ZHU ; Xiangyu LI ; Zhi LIANG ; Shuai GAO ; Zhuoyun WU ; Lin CHEN ; Weiheng CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(6):120-127
ObjectiveTo explore the medication characteristics and clinical efficacy of the Tenghuang Jiangu tablets in the treatment of knee osteoarthritis (KOA) in the remission stage in the real world,providing references for rational clinical use of this prescription. MethodBased on the "registration system of KOA treated with Tenghuang Jiangu tablets",2 439 KOA cases in the remission stage were analyzed by SPSS 25.0,IBM SPSS Modeler18.0,and Apriori algorithm. To be specific,the age,body mass index (BMI),and course of treatment were described in the form of x̄±s. The information on gender,K-L grade,daily dose,and frequency of drug use was described by frequency analysis. The number of cases,course of treatment,daily dose,and drug use frequency of the single-use group and the combined-use group were described by frequency analysis,and the combination of drugs was described by frequency analysis and Apriori algorithm. Mann-Whitney U test was employed to compare the scores of Visual Analogue Scale (VAS),Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC),pain,stiffness,and joint function between the single-use group and the combined-use group. ResultThe results of clinical treatment showed that 2 439 patients with KOA in the remission stage were treated with Tenghuang Jiangu tablets,with 1 432 (58.71%) in the single-use group and 1 007 (41.29%) in the combined-use group. The average daily dose of Tenghuang Jiangu tablets was (3.90±1.44) g,and the majority of the patients were at grade Ⅱ (54.47%). The daily average daily dose of Tenghuang Jiangu tablets in the single-use group was (3.64±1.35) g,which was lower than that in the combined-use group [(4.26±1.48) g,P<0.05]. In the combined use,the top three western medicines were glucosamine (270 times,14.68%),sodium hyaluronate (126 times,6.85%),and imrecoxib (116 times,6.31%),and the top three Chinese medicines were Huoxuezhitong capsules/tablets/ointments (31 times,1.69%),Biqi capsules (25 times,1.36%),and Maizhiling (23 times,1.25%). As for the overall clinical efficacy,the VAS score was (5.13±0.93) score before treatment and (2.22±1.18) score after treatment (P<0.05),with an overall average decrease of (2.91±1.14) score, and the average decrease in the single-use group was (2.76±1.43) score, which was lower than that in the combined-use group [(3.12±1.36) score,(P<0.01)]. The WOMAC score was (31.05±11.84) score before treatment and (13.55±9.91) score after treatment (P<0.05). The overall average decrease was (17.50±11.79) score, and the average decrease in the single-use group and combined-use group was (16.39±11.14) score and (19.08±12.50) score,respectively (P<0.01). The patients with KOA>grade Ⅱ accounted for 91.34%(1 308/1 432) and 93.55%(942/1 007) in the single-use group and combined-use group,respectively (χ2=80.026,P<0.05). A total of 43.37%(621/1 432) of the patients in the single-use group had other complications,lower than that in the combined-use group [54.92%(553/1 432),(χ2=20.087,P<0.01)]. ConclusionMore than half of the patients with KOA in the remission stage are treated with Tenghuang Jiangu tablets alone,and the combination therapy is mainly applied in patients with severe conditions or other complications. In relieving knee joint pain and improving joint stiffness and joint function,both the Tenghuang Jiangu tablets alone and the combination therapy are effective.
3.Analysis of non-tumor diseases affecting the diagnosis and treatment of cancer patients
Sen HAN ; Wei LI ; Jian FANG ; Jun NIE ; Ling DAI ; Weiheng HU ; Xiaoling CHEN ; Jie ZHANG ; Xiangjuan MA ; Guangmin TIAN ; Di WU ; Jieran LONG ; Jindi HAN ; Yang WANG ; Ziran ZHANG ; Weiping LIU ; Jun ZHU
Chinese Journal of Clinical Oncology 2018;45(10):517-520
Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2%) were selected. There were 773 men (67.0%) and 380 women (33.0%) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9%), respiratory system disease (17.0%) in 196 cases, digestive system disease in 107 cases (9.3%), skin and venereal diseases in 81 cases (7.0%), nervous system lesions (6.4%) in 74 cases, urinary system disease in 72 cases (6.2%), blood disease in 70 cases (6.1%), en-docrine and metabolic diseases in 47 cases (4.1%), autoimmune disease in 23 cases (2.0%), and other diseases (11.0%) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9%);no influence, 313 cases (27.1%);and uncertain, 69 cases (6.0%). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.
4.Timing of Brain Radiation Therapy Impacts Outcomes in Patients with Non-small Cell Lung Cancer Who Develop Brain Metastases
WANG YANG ; FANG JIAN ; NIE JUN ; DAI LING ; HU WEIHENG ; ZHANG JIE ; MA XIANGJUAN ; HAN JINDI ; CHEN XIAOLING ; TIAN GUANGMING ; WU DI ; HAN SEN ; LONG JIERAN
Chinese Journal of Lung Cancer 2016;19(8):508-514
Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). hTe aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes.Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemo-therapy or targeted therapy) were identiifed. hTe rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no signiifcant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease speciifc-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group.Results Me-dian overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 monthsvs 12.6 months;P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 monthsvs 3.0 months;P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy atfer the diagnosis of brain metastases as any line therapy improved the OS (20.0 monthsvs 10.7 months;P<0.01), whereas receiving TKI as ifrst line therapy did not (17.9 monthsvs 15.2 months;P=0.289).Conclusion Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospec-tive multi-central randomized study is imminently needed.
5.Expression of Connective Tissue Growth Factor in Patients With ST-segment Elevation Myocardial Infarction
Yong LI ; Li LI ; Chunmei QI ; Jun DIAO ; Weiheng WU ; Jianqi FENG
Chinese Circulation Journal 2015;(6):540-542
Objective: To detect the changes of serum level of connective tissue growth factor (CTGF) in patients with ST-segment elevation myocardial infarction (STEMI) and to study the correlation between CTGF level and the maximal activity of creatine kinase-MB (CK-MB). Methods: Our research included 2 groups of patients: STEMI group and unstable angina (UA) group. All patients were treated in our hospital from 2013-07 to 2014-06,n=50 in each group. In STEMI group, the serum levels of CTGF were examined by ELISA at 24h, 2, 7, 14 days of onset, and in UA group, CTGF level was examined at 24h of onset. The CK-MB activity levels were measured in STEMI group at the same time points by immunosuppression method. Results: The serum level of CTGF in UA patients at 24 h of onset was (10.34 ± 2.00) ng/mL, and in STEMI patients were (16.76 ± 3.17) ng/mL at 24h, (29.87 ± 4.90) ng/mL at 2d, (45.02 ± 8.35) ng/mL at 7d and (31.61 ± 4.40) at 14d. The CTGF levels in STEMI group at different time points were all higher than UA group at 24h of onset,P<0.01. In STEMI group, the CTGF levels were increasing from 24h to 7d, then decreasing at 14d, allP<0.01. In STEMI group, the highest protein concentration of CTGF was positively related to the maximal activity of CK-MB at 7 days of onset (r=0.859,P=0.000). Conclusion: CTGF expression has been up-regulated in STEMI patients which might be related to myocardial ifbrosis. The protein level of CTGF is related to MI size, it shows certain predictive value in relevant patients.
6.Clinical Characteristics of Coronary Slow Flow in Relevant Patients
Jing WANG ; Li LI ; Yong LI ; Jianqi FENG ; Cheng PENG ; Jun DIAO ; Ji HAO ; Weiheng WU
Chinese Circulation Journal 2015;(11):1035-1038
Objective: To explore the clinical and anatomical characteristics of coronary slow lfow (CSF) in relevant patients.
Methods: We summarized the patients without coronary angiography (CAG) proved coronary stenosis (stenosis < 40%) while with TIMI indicated CSF in our hospital from 2013-01 to 2015-01. The patients were divided into 2 groups: CSF group, n=56 patients having at least 1 major coronary artery with TIMI frame counts > 27 and Control group,n=55 patients with normal coronary lfow. The related laboratory indexes were examined and relationship between MCV and CSF was studied by multi-logistic regression analysis.
Results: In CSF group, MCV 90.4 (87.48, 92.65) fL and RDW-CV 12.5 (12.30, 13.18) % were lower than those in Control group 92.3 (90.1, 94.3) fL and 13(12.7, 13.4) %,P<0.05; while MCHC 337 (332, 347) g/L and the number of left circumlfex distal braches involved 3 (2, 4) were higher than those in Control group 327.5 (322, 338) g/L and 2 (2, 3),P<0.05. Multi-logistic regression analysis showed that MCV was negatively related to CSF (partial regression coefficient= -0.138, P=0.015), Spearman rank correlation analysis presented that MCV was negatively related to TIMI frame counts (r= -0.201, P=0.009).
Conclusion: Deformability of red blood cells might be involved in pathogenesis of CSF in relevant patients.
7.Effects of Local Radiation Combined with Chemotherapy in the treatment of Patients with Extensive-stage Small Cell Lung Cancer
WU DI ; FANG JIAN ; NIE JUN ; DAI LING ; CHEN XIAOLING ; ZHANG JIE ; HU WEIHENG ; HAN JINDI ; MA XIANGJUAN ; TIAN GUANGMING ; HAN SEN ; L0NG JIERAN ; WANG YANG
Chinese Journal of Lung Cancer 2015;(5):272-279
Background and objective Chemotherapy is a highly effcient primary treatment for extensive-stage small cell lung cancer (ES-SCLC). However, patients receiving such treatment are prone to develop drug resistance. Local treatment is palliative and thus can alleviate the local symptoms and improve quality of life, but limited evidence is available for prolonging survival. Hence, this study evaluated the role of local treatment in chemotherapy of patients with ES-SCLC. Methods A total of 302 ES-SCLC cases were enrolled in this retrospective study. Prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results Median progression-free survival (PFS) and median survival time (MST) of the patients were 4.4 and 10.4 months, respectively. 1-, 2-, and 3-year survival rates were 37.8%, 10.2%and 4.4%, correspondingly. hTe MST of the primary tumor radiotherapy plus chemotherapy group was 14.3 months, whereas that of the chemotherapy group was 8.2 months (P<0.01). hTe MSTs of multiple-site, single-site, and non-metastasis local treatments were 18.7, 12.3 and 8.9 months, respectively (P<0.01). hTe MSTs of initiative, passive, and non-metastasis local treatments were 16.0, 10.9 and 9.4 months, correspondingly (P<0.01). hTe MSTs of patients with prophylactic cranial irradiation (PCI) and those without PCI were 19.8 and 9.9 months, respectively (P<0.01). Primary tumor radiotherapy, metastasis local treat-ment, and PCI were independent prognostic factors for ES-SCLC. Conclusion Primary tumor radiotherapy, metastasis local treatment, and PCI can signiifcantly improve survival in patients with ES-SCLC.
8.Multivariate Analysis of Prognostic Factors in the Eldly Patients with Small Cell Lung Cancer:A Study of 160 Patients
CHEN XIAOLING ; FANG JIAN ; NIE JUN ; DAI LING ; ZHANG JIE ; HU WEIHENG ; HAN JINDI ; MA XIANGJUAN ; TIAN GUANGMING ; HAN SEN ; WU DI ; LONG JIERAN ; WANG YANG
Chinese Journal of Lung Cancer 2014;(1):15-23
Background and objective Lung cancer is currently the leading cause of cancer death, two thirds of patients are over the age of 65. Small cell lung cancer (SCLC) accounts for about15%-20%of all lung cancer. hTe objective of this study is to evaluate the survival of patients older than 65 with SCLC and analyze the independent prognostic factors in this group of patients. Methods A retrospective study has enrolled160 cases of lung cancer aged over 65. hTe prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results ①hTe median follow-up time was12 (2-109) months.1-, 3-, and 5-year survival rate was 47.1%,13.0%, 9.6%respectively, and 74.4%, 25.0%,19.7%for limited-stage (LD), and 36.8%, 8.7%, 5.8%for extensive-stage (ED). Median survival time (MST) of all the patients was12 months, 24 months for LD and11months for ED, respectively.②Multivariate analysis suggested that performance status (PS) pre-treatment, the change of PS atfer treatment, stage, liver metastases and thoracic radiotherapy were the independent prognostic factors in all patients.③For LD-SCLC patients, PS pre-treatment, thoracic radiotherapy were the independent prognostic fac-tors. hTe model of thoracic radiotherapy (concurrent chemoradiation vs sequential chemoradiation, early concurrent chemo-radiation vs late concurrent chemoradiation) and prophylactic cranial irradiation (PCI) did not show signiifcant difference.④For ED-SCLC patients, sex, the change of PS atfer treatment, chemotherapy, liver metastases, thoracic radiotherapy, PCI were the independent prognostic factors. Conclusion hTe survival time is related to PS and thoracic radiotherapy in eldly patients. Besides, it is also related to sex, chemotherapy, liver metastases and PCI for ED-SCLC.
9.Nursing of patients with primary open angle glaucoma underging implantation of EX-PRESS device
Xiaojuan WU ; Weiheng LING ; Huiming XIAO
Chinese Journal of Practical Nursing 2013;(12):9-11
Objective To determine the nursing measures of patients with primary open angle glaucoma undergoing implantation of EX-PRESS device.Methods 12 glaucomatous patients with EX-PRESS miniature glaucoma device received appropriate hygienic-education preoperatively,intensive nursing services during and after surgery,as well as health instructions in the follow-up period.Results 12 patients finally recovered from the surgery.The main post-operative complications were low tension and shallow anterior chamber(2 eyes),obstruction of the device by iris (1 eye).The intraocular pressures of all these patients remained normal levels before discharge and the visual acuity were the same as those pre-operation.Conclusions The effective nursing services for patients with EX-PRESS implantation is beneficial to the rehabilitation by increasing the adherence to the follow-up schedule,contributing to better understanding the common sense of the disease and the choice of the surgery.
10.The. Applied Value of Dynamic Monitoring the Level of D-dimer in the Patients with Postpartum Hemorrhage
Weiheng HE ; Liying ZHOU ; Ang WU
China Modern Doctor 2009;47(18):92-93
Objective To dynamic monitor the level of D--dimer after transfusion treatment of postpartum hemorrhage and the possibility of thrombosis. Methods To retrospective analyze and compare of the level of D-dimer of 10 cases with postpartum hemorrhage, while the one in 20 eases of normal confinement in our hospital of year 2008. Results The level of D-dimer in the ease of postpartum hemorrhage was significantly higher than the one in the ease of normal confinement, and this difference indicated important significance(P<0.01).Dynamic monitoring 10 eases of emergency treatment of patients with plasma D-dimer levels with the effective condition improved after treatment and gradually decreased. Conclusion D-dimer is the main mark of secondary fibrinolysis, and the results reflect the function of D-dimer in vascular endothelial injury and blood coagulation, anti-coagulation and fibrinolytie. Furthermore, it has important significance in the understanding of the body's blood coagulation status and the prediction of mierothrombus formation, bleeding tendency, or the occurrence and development of disseminated intravaseular coagulation(DIC), development

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