Objective To investigate the indications,therapeutic effects,and compatibility patterns of modified Sini San formulas.Methods Modified Sini San formulas recorded in the Selected Compilation of Encyclopedia of Chinese Medicinal Formulas were retrieved.Frequency analysis,cluster analysis,and association rule mining were performed on the herbs of Sini San modified formulas.Results A total of 34 modified Sini San formulas were included,involving 127 additional medicinals.Analysis of the properties,flavors,and meridian tropism of the top 30 high-frequency additional medicinals,including Chuanxiong Rhizoma,Angelicae Sinensis Radix,Scutellariae Radix,Cortex Magnoliae Officinalis,Rehmanniae Radix,Rhei Radix et Rhizoma,Poria,Ginseng Radix et Rhizoma,Cyperi Rhizoma,Pinelliae Rhizoma,Atractylodis Rhizoma,and Citri Reticulatae Pericarpium,revealed that the additional medicinals were predominantly warm in nature,bitter in flavor,and acted the spleen meridian.Cluster analysis yielded six categories of medicinal combinations.Association rule mining identified that Sini San was frequently prescribed by combining with single herbs of Chuanxiong Rhizoma,Angelicae Sinensis Radix,and Rehmanniae Radix,or with herbal groups of Chuanxiong Rhizoma-Angelicae Sinensis Radix,Angelicae Sinensis Radix-Rehmanniae Radix,Angelicae Sinensis Radix-Persicae Semen,Angelicae Sinensis Radix-Carthami Flos,Platycodonis Radix-Chuanxiong Rhizoma,and Carthami Flos-Persicae Semen-Angelicae Sinensis Radix.Conclusion Later physicians have expanded the application of Sini San after modification to treat externally contracted diseases with exterior syndrome,epidemic diseases,abdominal masses,eye disorders,and other conditions.Sini San is often used in combination with formulas such as Taohong Siwu Decoction and Yueju Pills.Commonly-paired additional medicinals fall into six primary categories corresponding to its expanded therapeutic applications,i.e.,stasis-resolving,blood-activating,exterior-releasing,qi-regulating,deficiency-supplementing,and purgative medicinals.The analytical results may provide new insights for modern clinical applications-pharmacological research on Sini San.

Objective:To identify the dosimetric and radiobiological differences of three radiotherapy techniques of whole breast irradiation with simultaneous integrated boost (WBI-SIB) following breast-conserving surgery for early breast cancer (EBC).Methods:The data of 20 patients with early left-sided breast cancer who received radiotherapy following breast-conserving surgery were retrospectively analyzed. Three radiotherapy techniques, namely hybrid intensity-modulated radiotherapy (HIMRT), intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT), were redesigned with the same prescription dose and target conditions. Then, doses to target volume (TV) and organs at risk (OAR), along with the normal tissue complication probability (NTCP) and secondary cancer risk (SCR) for specific organs, were compared.Results:Compared to HIMRT and IMRT, VMAT led to significant decreases in various dosimetric indices of the affected lung and heart and increases in the Dmean doses to the healthy lung and healthy breast and V5 Gy doses to the healthy breast, with the differences being significantly different ( P < 0.05). The average NTCP values of cardiac death, radiation pneumonitis, and pulmonary fibrosis induced by VMAT were 0.41%, 1.62%, and 23.59%, respectively, significantly lower than those caused by other two techniques ( P < 0.05). No statistical differences were found in 10 dosimetric indices of OAR between IMRT and HIMRT, while the NTCP analysis suggested that the risks of cardiac death ( t = 2.70, P < 0.05) and pulmonary fibrosis ( t =4.11, P < 0.05) induced by IMRT were slightly lower than those caused by HIMRT. In addition, the excess absolute risk (EAR) to the healthy lung posed by VMAT was 1.65 and 1.83 times those induced by HIMRT and IMRT, respectively ( z = -3.92, t = -6.43, P < 0.05). In contrast, the EAR to the healthy breast induced by VMAT was 2.79 and 2.65 times those posed by HIMRT and IMRT, respectively ( z = -3.21, -3.70, P < 0.05). Conclusions:Among three intensive-modulated radiotherapy techniques of WBI-SIB for EBC, VMAT provides the optimal protection for the heart and affected lung but leads to the highest SCR to the healthy lung and breast. When VMAT is employed for young EBC patients or those with normal cardiopulmonary function, special attention should be paid to reducing low-dose irradiations to the healthy breast and thereby minimizing SCR. In contrast, VMAT might be more favorable for patients with pronounced cardiopulmonary risks or aged patients.

Objective To explore the reliability of the modified Penn spasm frequency scale (MPSFS),the spinal cord assessment tool for spasticity (SCATS),the spinal cord injury spasticity evaluation tool (SCI-SET) and visual analogue scales (VASs) and their inter-correlation so as the provide evidence for clinical application.Methods The spasticity of thirty-five patients with spinal cord injury was assessed by 2 raters using the 4 scales with an interval of half an hour between assessments.Three days later,all of the subjects were again evaluated by one of the 2 raters in the same environment.The intra-class correlation coefficient (ICC),standard error of measurement (SEM) and minimal detectable difference (MDD95) were calculated,and the correlations among the 4 scales were analyzed.Results The test-retest ICC for the MPSFS was 0.94 and the inter-rater reliability ICC was 0.90.For the SCATS they were 0.948 and 0.939 respectively.,For the VAS they were 0.962 and 0.974,and for the SCI-SET they were 0.969 and 0.989.There was significant inter-correlation among all four scales,with negative correlation between the SCI-SET and the others.The observed correlations were all of medium strength (r=-0.421 to-0.5),except for a high correlation between the SCI-SET and VAS results (r=0.55 to 0.94).Conclusion The MPSFS,SCATS,VAS and SCI-SET are all reliable tools for evaluating spasticity among people with spinal cord injury.All can be applied in clinical practice.

Objective: To observe the clinical effect of pestle needle combined with Chinese herbal fumigation on cervical spondylosis and provide a safe effective therapy for this condition. Methods: A total of 54 cases were randomly allocated into two groups (27 cases in each group) according to their sequence of consultation. Patients in both groups were treated with the same Chinese herbal fumigation. Patients in the treatment group were additionally treated with pestle needle therapy on a unique set ofBa Zhen points around Dazhui (GV 14), Fengfu (GV 16) and the distance between Naohu (GV 17) and Dazhui (GV 14) along theHe Chepathway, whereas patients in the control group were additionally treated with routine acupuncture therapy. Then the short-term and long-term efficacies were observed and compared after treatment using the visual analog scale (VAS) and pain rating index (PRI). Results: At the end of treatment, VAS scores were significantly decreased in both groups, and the VAS score in the treatment group was lower than that in the control group (P<0.05). The intra-group differences were statistically significant in VAS scores 1 month, 3 and 6 months after treatment (allP<0.05). At the end of treatment, the sensory and total PRI scores in the treatment group were significantly lower than those in the control group, showing statistically significant differences (both P<0.01); and there was no significant between-group difference (P>0.05) in the affective PRI score. At the end of treatment, the total effective rate was 85.2% in the treatment group, versus 65.4% in the control group, showing a statistical significance (P<0.05). The follow-up six months later showed that the total effective rate was 92.6% in the treatment group, versus 76.9% in the control group, showing a statistical significance (P<0.05). Conclusion: Pestle needle therapy is a stable and positive therapy for cervical spondylosis.

Objective To compare the clinical efficacy and radiologic changes between constrained and non-constrained titanium plate in anterior cervical corpectomy and fusion (ACCF) in elderly cervical spondylosis patients.Methods A total of 58 elderly cervical spondylosis patients who underwent ACCF were divided into group 1 (patients treated with constrained titanium plates,n =30) and group 2 (patients treated with non-constrained titanium plates,n=28).The Japanese Orthopedic Association (JOA) score,fusion rate,the loss of segmental height and cervical lordosis were recorded.The clinical efficacy and imaging features were compared between the two groups.Results The improvement rate of JOA score had no significant differences between group 1 and group 2 [(77.7±18.6)％ vs.(75.8±23.2)％,t=0.340,P＞0.05].At 3 months after operation,the fusion rate was higher in group 2 than in group 1 (89.3％ vs.63.3％,x2 =5.327,P＜0.05).At 3,6 and 12 months after operation,there were no significant differences in the loss of segmental cervical height and lordosis between group 1 and group 2 [(2.42±3.05)mm vs.(0.98±2.86)mm,(3.95±3.65)mm vs.(2.34±2.97)mm,(3.60±4.33)mm vs.(2.40±2.96)mm,(1.64±2.33)° vs.(0.66 ± ±2.14)°,(2.13∧±±3.79)° vs.(0.70±2.99)°,(2.39±4.26)° vs.(0.86±3.25)°,respectively,all P ＞0.05].Conclusions The clinical efficacy is similar in ACCF with the two types of titanium plates.The non-constrained titanium plate can increase the fusion rate in early time,but may aggravate the loss of segmental cervical height and lordosis,which should be used with caution in elderly osteoporosis patients.