This study aimed to explore the efficacy and safety of Tangmaikang Granules in the treatment of diabetic peripheral neuropathy(DPN). PubMed, Cochrane Library, EMbase, SinoMed, CNKI, Wanfang and VIP were retrieved for randomized controlled trial(RCT) of Tangmaikang Granules in the treatment of DPN. Cochrane handbook 5.3 was used to evaluate the quality of the inclu-ded studies, and RevMan 5.4.1 and Stata 15.1 were employed to analyze data and test heterogeneity. GRADEpro was used to assess the quality of each outcome index. Clinical effective rate was the major outcome index, while the improvement in numbness of hands and feet, pain of extremities, sluggishness or regression of sensation, sensory conduction velocity(SCV) and motor conduction velocity(MCV) of median nerve and peroneal nerve, fasting blood glucose(FBG), 2 h postprandial blood glucose(2hPBG), and glycated hemoglobin(HbA1c) and incidence of adverse reactions were considered as the minor outcome indexes. A total of 19 RCTs with 1 602 patients were eventually included. The Meta-analysis showed that the improvements in clinical effective rate(RR=1.45, 95%CI[1.32, 1.61], P<0.000 01), pain of extremities(RR=1.70, 95%CI[1.27, 2.27], P=0.000 3), MCV of peroneal nerve(MD=4.08, 95%CI[3.29, 4.86], P<0.000 01) and HbA1c(SMD=-1.23, 95%CI[-1.80,-0.66], P<0.000 1) of Tangmaikang Granules alone or in combination in the experimental group were better than those in the control group. Compared with the conditions in the control group, numbness of hands and feet(RR=1.42, 95%CI[1.12, 1.80], P=0.003), sluggishness or regression of sensation(RR=1.41, 95%CI[1.05, 1.91], P=0.02), SCV of median nerve(MD=4.59, 95%CI[0.92, 8.27], P=0.01), SCV of peroneal nerve(MD=4.68, 95%CI[3.76, 5.60], P<0.000 01) and MCV of median nerve(MD=5.58, 95%CI[4.05, 7.11], P<0.000 01) of Tangmaikang Granules in combination in the experimental group were improved by subgroup analysis. The levels of FBG(MD=-0.57, 95%CI[-1.27, 0.12], P=0.11) and 2hPBG(MD=-0.69, 95%CI[-1.70, 0.33], P=0.18) in the experimental group were similar to those in the control group after treatment with Tangmaikang Granules alone or in combination. There was no difference in the safety(RR=1.28, 95%CI[0.58, 2.82], P=0.54) of Tangmaikang Granules in the treatment of DPN between the experimental group and the control group. Tangmaikang Granules could significantly increase clinical effective rate and nerve conduction velocity as well as improve symptoms of peripheral nerve and blood glucose level, and no serious adverse reactions were identified yet. Further validation was needed in future in large-sample, multicenter, high-quality RCTs.
Humans ; Blood Glucose ; Diabetic Neuropathies/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Glycated Hemoglobin ; Hypesthesia/drug therapy* ; Multicenter Studies as Topic ; Pain/etiology* ; Treatment Outcome ; Peripheral Nervous System Diseases/etiology*

Raynaud syndrome is a medical condition that causes pain, numbness, and changes in skin color at the distal extremities. Raynaud syndrome can be subdivided into primary Raynaud's and secondary Raynaud's. The former is diagnosed when the cause is unknown and the latter is caused by an underlying condition, such as connective tissue diseases, injury, smoking, or certain medications. Both cancer chemotherapy and β-blockers are relatively common causes of Raynaud syndrome but there are no reports of its association with methimazole administration. The authors encountered a 43-year old woman with hyperthyroidism who developed digital ulcers associated with Raynaud syndrome after a methimazole treatment. Her digital ulcers and Raynaud syndrome were improved after methimazole was replaced with propylthiouracil and conventional therapy. This paper reports this case along with a review of the relevant literature.
Connective Tissue Diseases ; Drug Therapy ; Extremities ; Female ; Humans ; Hyperthyroidism ; Hypesthesia ; Methimazole* ; Propylthiouracil ; Skin Pigmentation ; Smoke ; Smoking ; Ulcer

BACKGROUND: Various etiologies are the causative agents for sciatic neuropathy. We present here a case of ischemic sciatic neuropathy in a patient with liposarcoma. CASE REPORT: A 55-year-old woman presented with severe pain and weakness of the left leg. She had a history of recurred retroperitoneal liposarcoma, and was being administered chemotherapy. Examination revealed weakness in ankle dorsiflexion, plantar flexion and hamstring. Complaints also included dysesthesia, and numbness in the sole and dorsum of the foot. Nerve conduction study showed low compound muscle action potentials and slow motor conduction velocity of left peroneal and tibial nerves, with indiscernible sensory nerve action potentials of the left superficial peroneal and sural nerves. Computed tomography angiography revealed occlusion of the left common iliac artery. Commencement of intravenous infusion of heparin resulted in skin color change and progression of the weakness. Hence, the patient underwent an emergency thrombectomy. CONCLUSIONS: Ischemia should be considered as a cause of sciatic neuropathy in cancer patients, which requires management with timely treatment.
Action Potentials ; Angiography ; Ankle ; Drug Therapy ; Emergencies ; Female ; Foot ; Heparin ; Humans ; Hypesthesia ; Iliac Artery ; Infusions, Intravenous ; Ischemia ; Leg ; Liposarcoma ; Middle Aged ; Neural Conduction ; Paresthesia ; Sciatic Neuropathy ; Skin Pigmentation ; Sural Nerve ; Thrombectomy ; Tibial Nerve

Myeloid sarcoma is a rare tumor mass consisting of immature granulocytic cells occurring in an extramedullary site or in a bone. It has often been observed during the course of an acute leukemia, myelodysplastic syndrome or myeloproliferative neoplasms, and it can involve any site of the body. However, it rarely present in the absence of bone marrow infiltration, especially for the isolated spinal myeloid sarcoma. In this report, we describe a case of isolated myeloid sarcoma that showed spinal compression. A 66-year-old male, with no underlying disease or medication history, presented with a progressive back pain and numbness in bilateral lower extremities that had begun two weeks before. He was diagnosed with myeloid sarcoma with no evidence of bone marrow involvement. Tumor cells were positive for CD34, c-KIT, and Bcl-2 on the immunohistochemical stain. He was treated with systemic chemotherapy with daunorubicin plus cytosine arabinoside and achieved a partial response.
Aged ; Back Pain ; Bone Marrow ; Cytarabine ; Daunorubicin ; Drug Therapy ; Humans ; Hypesthesia ; Leukemia ; Lower Extremity ; Male ; Myelodysplastic Syndromes ; Sarcoma, Myeloid* ; Spinal Cord Compression

Occasionally, unexpected neurological deficits occur after lumbar spinal surgery. We report a case of monoparesis after lumbar decompressive surgery. A 63-year-old man, who had undergone decompression of L4-5 for spinal stenosis 4 days previously in the other hospital, visted the emergency department with progressive weakness in the left leg and hypoesthesia below sensory level T7 on the right side. He had been cured of lung cancer with chemotherapy and radiation therapy 10 years previously, but detailed information of radiotherapy was not available. Whole spine magnetic resonance (MR) imaging showed fatty marrow change from T1 to T8, most likely due to previous irradiation. The T2-weighted MR image showed a high-signal T4-5 spinal cord lesion surrounded by a low signal rim, and the T1-weighted MR image showed focal high signal intensity with focal enhancement. The radiological diagnosis was vascular disorders with suspicious bleeding. Surgical removal was refused by the patient. With rehabilitation, the patient could walk independently without assistance 2 months later. Considering radiation induced change at thoracic vertebrae, vascular disorders may be induced by irradiation. If the spinal cord was previously irradiated, radiation induced vascular disorders needs to be considered.
Bone Marrow ; Decompression ; Delayed Diagnosis* ; Diagnosis ; Drug Therapy ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Hypesthesia ; Leg ; Lung Neoplasms ; Middle Aged ; Paresis ; Radiotherapy ; Rehabilitation ; Spinal Cord* ; Spinal Stenosis ; Spine ; Thoracic Vertebrae

STUDY DESIGN: Multicenter prospective study with a crossover design. PURPOSE: The objective of this study is to compare the efficacy of limaprost alfadex (LP) and elcatonin (EL) for lumbar spinal stenosis (LSS) patients with concurrent osteoporosis. OVERVIEW OF LITERATURE: It has been increasingly important to improve quality of life by establishing appropriate conservative treatments for LSS patients with concurrent osteoporosis who will presumably continue to increase due to the percentage of the aging elevations, however there is no prospective study. METHODS: A total of 19 patients with LSS and concurrent osteoporosis were enrolled in this study. The patients were divided into two groups and compared using a crossover design. The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and short-form (SF)-8 health survey scale were used for clinical evaluations. RESULTS: There was a significant improvement of buttock-leg pain and numbness in the EL group. A significant improvement of impaired walking function was noted for the LP group according to the JOABPEQ while the rest of the items in the JOABPEQ showed no significant differences. The SF-8 health survey revealed that somatic pains and physical summary scores in the EL group and physical functioning and physical summary scores in the LP group tended to improve but not to any statistically significant extents. CONCLUSIONS: Concomitant uses of EL may be useful in patients who do not respond satisfactorily to the treatments of LP for 6-8 weeks.
Aging ; Asian Continental Ancestry Group ; Back Pain ; Cross-Over Studies* ; Drug Therapy ; Health Surveys ; Humans ; Hypesthesia ; Nociceptive Pain ; Osteoporosis* ; Prospective Studies ; Quality of Life ; Spinal Stenosis* ; Walking ; Surveys and Questionnaires

Intramedullary spinal cord metastasis (ISCM) is an uncommon condition of the central nervous system (CNS) cause by systemic malignant tumors. Most ISCM cases are known to occur in patients with lung cancer and breast cancer; however, ISCM also very rarely occurs in patients with colorectal cancer. For the first time in Korea, we experienced a case of ISCM arising from rectal cancer, where a 75-year-old man presented with an abruptly-developed left-foot drop and numbness in both legs. The patient had lung metastases from rectal cancer that had been treated with chemotherapy. Magnetic resonance imaging revealed an intramedullary nodular lesion at the T12 level. ISCM was diagnosed and treated with steroids and radiotherapy. The patient's neurological symptoms were relieved for a while after treatment, but his condition deteriorated progressively. He died 4 months after ISCM had been diagnosed.
Aged ; Breast Neoplasms ; Central Nervous System ; Colorectal Neoplasms ; Drug Therapy ; Humans ; Hypesthesia ; Korea ; Leg ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Radiotherapy ; Rectal Neoplasms* ; Spinal Cord Neoplasms ; Spinal Cord* ; Steroids

Child ; Folic Acid ; administration & dosage ; therapeutic use ; Folic Acid Antagonists ; adverse effects ; Hematinics ; administration & dosage ; therapeutic use ; Humans ; Hypesthesia ; chemically induced ; drug therapy ; Injections, Spinal ; Leukoencephalopathies ; chemically induced ; Male ; Methotrexate ; adverse effects ; Quadriplegia ; chemically induced ; drug therapy ; Time Factors ; Vitamin B Complex ; administration & dosage ; therapeutic use

OBJECTIVETo observe the therapeutic effect of digital acupoint pressure for treatment of the nerve root type of cervical spondylosis.

METHODSFour hundred cases were randomly divided into a digital acupoint pressure group (DAP group) and a medicine group, 200 cases in each group. Acupoints of Quepen (ST 12), Jianjing (GB 21) and Tianzong (ST 11) etc. were used for digital pressing in the DAP group; and Chinese herb medicine of Gentongping was routinely taken in the medicine group. After three treatment courses, the symptoms of pain and numbness, the signs of pressure measurement by compression of head, brachial plexus drawer test and arm myodynamia, as well as the total cumulative scores of daily living capability, were compared.

RESULTSAfter treatment, the total cumulative scores of numbness, pressure measurement by compression of head, brachial plexus drawer test, arm myodynamia and daily living capability in both groups were obviously better than those of before treatment (all P<0.01); but there was a significant difference on the total cumulative score of the symptoms and signs between the two groups. The cured rate of 78.0% and total effective rate of 99.0% in the DAP group were better than those of 61.0% and 87.0% in the medicine group, respectively (both P<0.01).

CONCLUSIONDigital acupoint pressure plays an active role in improving the symptoms and signs on patients with nerve root type of cervical spondylosis, which is better than Chinese herb medicine of Gentongping.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hypesthesia ; drug therapy ; physiopathology ; therapy ; Male ; Massage ; Middle Aged ; Spondylosis ; drug therapy ; physiopathology ; therapy ; Young Adult

PURPOSE: Pharmacotherapy using selective serotonin reuptake inhibitors(SSRls) for men with primary premature ejaculation(PE) is promising. Specially, a strategy taking a pill "as needed" may offer an attractive option. To investigate the possibility of self therapy, patients treated for PE with sertraline "as needed" basis were evaluated. MATERIALS AND METHODS: Since 1996 we have treated 24 males with sertraline "as needed" basis for primary PE. We chose sertraline among SSRIs because alarge dose need not to be divided and peak plasma levels occurring 4-8 hours after oral administration makes 5 p.m. suitable for the time of administration. Five p.m. is the time the ordinary men usually fix their evening schedule including intercourses. Each patient was started on 50mg qd for 2 weeks and then the dose was adjusted to 50 or 100mg only on the day of intercourse. RESULTS: After 6 weeks, 18 men continued to take medication and 6 had dropped out. Of 18 men, mean ejaculation latency were 23 +/-19sec before treatment, 5.9 +/-4.2min after 2wks 50mg qd, 5.1 +/-3.8min after 2wks 50/100mg pm and 4.5 +/-2.7min after 4wks 50/100mg prn and mean sexual satisfaction scores ('5"=extremely satisfied, "0"=extremely unsatisfied) of men were 0.8 +/-0.8 before treatment, 3.8 +/-1.2 after 2wks 50mg qd, 3.4 +/-1.0 after 2wks 50/100mg pm and 3.2 +/-0.7 after 4wks 50/100mg pm. And mean sexual satisfaction scores of partners were 1.1 +/-0.7 before treatment, 3.2 +/-1.6 after 2wks 50mg qd,3.1 +/-1.4 after 2wks 50/100mg pm and 3.3 +/-1.2 after 4wks 50/100mg pm. Side effects were intermittent excessive delay in 1 patient, fatigue in 2 patients, numbness in 1 patient. CONCLUSIONS: If our results were supported by additional clinical long term study, self therapy with sertraline given pm at 5 pm in treatment of PE could be as attractive as self injection therapy in the treatment of erectile dysfunction.
Administration, Oral ; Appointments and Schedules ; Drug Therapy ; Ejaculation ; Erectile Dysfunction ; Fatigue ; Follow-Up Studies* ; Humans ; Hypesthesia ; Male ; Plasma ; Premature Ejaculation* ; Serotonin ; Sertraline*