Objective:To evaluate the clinical efficacy of umbilical herbal application combined with pestle needle therapy in the treatment of functional diarrhea(FD)due to deficient cold of the spleen and stomach.Methods:A tota...Objective:To evaluate the clinical efficacy of umbilical herbal application combined with pestle needle therapy in the treatment of functional diarrhea(FD)due to deficient cold of the spleen and stomach.Methods:A total of 72 patients with FD were enrolled and randomly assigned to two groups using the random number table method,with 36 patients in each group.Both groups received conventional Western medication treatment.The observation group additionally received umbilical application of Wen Yang Bu Pi Gao(Yang-warming and spleenstrengthening herbal paste)combined with pestle needle therapy.After 7 d of treatment,the clinical efficacy was assessed.Traditional Chinese medicine(TCM)symptom scores,irritable bowel syndrome-quality of life(IBS-QOL)score,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group was 91.7%,which was significantly higher than 69.4%in the control group(P<0.05).After treatment,TCM symptom and IBS-QOL scores in both groups were significantly reduced compared to those before treatment(P<0.05),and the scores in the observation group were significantly lower than those in the control group(P<0.05).No adverse reactions occurred in either group during the treatment period.Conclusion:Compared to conventional Western medication treatment alone,the addition of umbilical application of Wen Yang Bu Pi Gao combined with pestle needle therapy can more effectively alleviate clinical symptoms and improve the quality of life in patients with FD due to deficient cold of the spleen and stomach.展开更多
AIM:To describe the prevalence and changes in treatment patterns of ranibizumab and photodynamic therapy(PDT)among retinal disease patients who attended the Ophthalmology Clinic in the tertiary care Hospital Selayang ...AIM:To describe the prevalence and changes in treatment patterns of ranibizumab and photodynamic therapy(PDT)among retinal disease patients who attended the Ophthalmology Clinic in the tertiary care Hospital Selayang from 2010 to 2014.METHODS:Study subjects were recruited retrospectively using the Electronic Medical Record(EMR)database software in Hospital Selayang.Demographic data,medical history,diagnostic procedure,treatments and diagnosis of patients were recorded.RESULTS:The five-year analysis included 821 patients with a mean age of 65.9±11.73 y.Overall,there were a highernumber of males(63.1%)and a higher number of Chinese(47.4%)patients.Among the 821 patients,62.9%received ranibizumab injection followed by 19.2%PDT therapy and 17.9%had ranibizumab combined with PDT therapy.Age-related macular degeneration(AMD)and polypoidal choroidal vasculopathy(PCV)were the most common retinal eye diseases reported,recording prevalence of 25.0%and 45.6%,respectively.The trend in ranibizumab treatment was reported to increase while PDT showed a decrease in trend from year 2010 to 2014.In terms of treatment,following multiple logistic regression,AMD was associated with the subjects being more likely to have received ranibizumab monotherapy(P〈0.001)while PCV was associated with more likely to have received PDT(P〈0.001)and PDT combined with ranibizumab therapy(P〈0.001).CONCLUSION:The tertiary care setting in Malaysia is consistent with management of patients from other countries whereby ranibizumab is the most common treatment given to patients with AMD,while PCV patients most commonly receive PDT and ranibizumab combined with PDT therapy.展开更多
OBJECTIVE: Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and healthrelated quality of life(HRQOL) are common diagnostic measures for cancer pa...OBJECTIVE: Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and healthrelated quality of life(HRQOL) are common diagnostic measures for cancer patients, the association between them has not been studied. This study aimed to describe the changes in the pattern of symptoms of Yang-deficiency, Yin-deficiency, blood stasis, and HRQOL before and after chemotherapy,and to examine the association between the patterns and the cancer patients' HRQOL.METHODS: A panel study was undertaken with 123 cancer patients who were about to begin their first course of chemotherapy at four teaching hospitals in Taiwan. A structured questionnaire was used before and after chemotherapy. HRQOL was assessed using the Medical Outcomes Survey Short-Form 36. The Traditional Chinese Medical Constitutional Scale was used to measure Yang-deficiency, Yin-deficiency, and blood stasis patterns,with higher scores indicating a larger deficiency.RESULTS: The patients had significantly worse scores for Yang-deficient pattern, Yin-deficiency pattern, blood stasis pattern, and the physical components of HRQOL after chemotherapy compared with before chemotherapy. The HRQOL scores correlated significantly with Yang-deficiency, Yin-deficiency, and the blood stasis pattern scores. A generalized estimating equation model showed that the HRQOL scores were significantly worse after chemotherapy compared with before chemotherapy for the physical component, but not for the mental component. Blood stasis pattern was significantly associated with a decreased HRQOL in both the physical and mental components. A hemoglobin level < 12 g/d L was associated with a worse physical component of HRQOL.CONCLUSION: The Yang-deficiency, Yin-deficiency,and blood stasis patterns were all associated with lower HRQOLincancerpatientsafterchemotherapy.展开更多
Introduction: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the third leading cause of cancer deaths in the United States. The goal of this study was to understand treatment patterns, biomark...Introduction: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the third leading cause of cancer deaths in the United States. The goal of this study was to understand treatment patterns, biomarker testing practices, treatment adherence, and the clinical and economic outcomes associated with chemotherapy for metastatic disease. Methods and Materials: We retrospectively examined electronic health records of patients with metastatic CRC who initiated chemotherapy between 01 January 2007 and 30 June 2011, with follow-up to 30 June 2012. Parameters analyzed included demographics and clinical characteristics, treatment patterns, clinical outcomes, and health care resource utilization. Results: In the analysis, 756 patients were included;median age was 61 years (55% male) at start of first line therapy. The most commonly used regimens in the first, second, and third line were FOLFOX + bevacizumab (46%), FOLFIRI + bevacizumab (23%), and irinotecan + cetuximab (23%) respectively. Adherence to guidelines decreased with increasing line of therapy. When assessed by treatment backbone categories in the third line, outcome measures including overall survival (OS), and time to treatment discontinuation (TTD) were not statistically different between groups. In the multivariable model, body mass index (BMI), performance status, and KRAS were significant predictors of survival. Conclusions: This study provides insight into patterns of care and outcomes of mCRC patients for the aforementioned time period. As treatment options for mCRC evolve, it is valuable to understand the continuum of care to help inform future treatment among candidates for continued therapy.展开更多
Cerenkov radiation(CR)can serve as a source of internal light to overcome the limited tissue penetration of external light in conventional photodynamic therapy(PDT).However,insufficient luminescence intensity hinders ...Cerenkov radiation(CR)can serve as a source of internal light to overcome the limited tissue penetration of external light in conventional photodynamic therapy(PDT).However,insufficient luminescence intensity hinders the clinical application of CR-PDT.Here,we developed a glutathione-responsive biomimetic nanoplatform by fusing cancer cell membranes and liposomes loaded with photosensitizer hematoporphyrin monomethyl ether(HMME)and a radiation energy amplifier Eu^(3+),named HMME-Eu@LEV.Colloidal Eu^(3+)convertsγ-radiation and CR from radioisotopes into fluorescence to enhance antitumor effects.Sequential administration ensures co-localization of HMME-Eu@LEV and radiopharmaceutical^(18)F-fluorodeoxyglucose(FDG)at the tumor site,triggering enhanced CR-PDT and immunogenic cell death.Our observations indicated that luminescence resonance energy transfer between Eu^(3+)and HMME was efficient,and Cerenkov luminescence from Eu@LEV+FDG was approximately 5.6-fold higher in intensity than that from FDG alone.As a result,abundant ROS were generated,and macrophages in the tumor microenvironment were polarized from M2 to M1.In addition,the immunosuppressive tumor microenvironment could be reversed by promoting the maturation of dendritic cells and infiltration of cytotoxic T lymphocytes.The activated immune system effectively inhibited the growth of primary tumors and spread of distant metastases.Our work demonstrates the feasibility of CR-PDT without an external light source and the critical role of nanomaterials in personalized medicine.展开更多
Objective To investigate three representative conditions,gallbladder colic,renal colic,and primary dysmenorrhea,to identify trends and regularities in acupoint selection and provide evidence-based references for clini...Objective To investigate three representative conditions,gallbladder colic,renal colic,and primary dysmenorrhea,to identify trends and regularities in acupoint selection and provide evidence-based references for clinical practice.Methods Clinical studies on acupuncture for gallbladder colic,renal colic,and primary dysmenorrhea published between 2006 and 2025 were retrieved from the Chinese National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Wanfang,and PubMed.Bibliometric analysis was performed using IBM SPSS Modeler 18.0,and the Apriori algorithm was applied to evaluate acupoint-use patterns.Results The analysis demonstrated that commonly selected acupoints for these conditions have remained relatively consistent over the past two decades.Frequently used acupoints for gallbladder colic included Yanglingquan(GB 34),Dannang(EX-LE 6),Qiuxu(GB 40),Taichong(LR 3),Danshu(BL 19),Zusanli(ST 36),Qimen(LR 14),Riyue(GB 24),and Ganshu(BL 18).For renal colic,the most frequently reported points were Shenshu(BL 23),Sanyinjiao(SP 6),Zusanli(ST 36),Yinlingquan(SP 9),Jingmen(GB 25),Guanyuan(CV 4),Ashi points,Zhongji(CV 3),and Pangguangshu(BL 28).The main acupoints for primary dysmenorrhea were Sanyinjiao(SP 6),Guanyuan(CV 4),Ciliao(BL 32),Diji(SP 8),Shiqizhui(EX-B 8),Zhongji(CV 3),Zusanli(ST 36),Zigong(EX-CA 1),and Qihai(CV 6).On average,treatment protocols employed 3-4 acupoints per session.Conclusions The most frequently selected acupoints for visceral smooth muscle spasmodic pain were located within the ganglion segment innervation areas,showing close association with the target organs.Furthermore,treatment protocols typically involved a small number of acupoints.These findings highlight the need for further systematic research,particularly randomized controlled trials,to validate and strengthen the evidence base.展开更多
Objective:To observe the efficacy of acupuncture combined with traditional Chinese herbs in the treatment of poststroke vascular dementia(VD)and the effects on serum interleukin(IL)-6 and superoxide dismutase(SOD).Met...Objective:To observe the efficacy of acupuncture combined with traditional Chinese herbs in the treatment of poststroke vascular dementia(VD)and the effects on serum interleukin(IL)-6 and superoxide dismutase(SOD).Methods:A total of 240 patients with poststroke VD were selected and randomly divided into two groups according to the random number table method,with 120 cases in each group.Both groups received Hua Tan Tong Luo(phlegmresolving and collateral-activating)formula,once daily;the observation group was additionally treated with Yi Shen Tiao Du(kidney-tonifying and Governor Vessel-regulating)acupuncture once daily for 6 consecutive days,followed by 1 d of rest.Both groups were treated for 15 d as one course,for a total of 2 courses.After treatment,the total effective rate was compared.Changes in scores of traditional Chinese medicine(TCM)symptoms,clinical dementia rating(CDR),National Institutes of Health stroke scale(NIHSS),and Chinese version of mini-mental state examination(MMSE),and serum levels of IL-6 and SOD were observed in both groups.Results:The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,TCM symptom,CDR,and NIHSS scores,and serum IL-6 levels in both groups were lower than those before treatment(P<0.05),while MMSE scores and serum SOD levels were higher than those before treatment(P<0.05).After treatment,the observation group showed lower TCM symptom,CDR,and NIHSS scores,and serum IL-6 levels than the control group(P<0.05),and higher MMSE scores and serum SOD levels than the control group(P<0.05).Conclusion:Compared to Hua Tan Tong Luo formula alone,Yi Shen Tiao Du acupuncture combined with Hua Tan Tong Luo formula demonstrates better efficacy in reducing dementia severity,improving cognitive and neurological function,and inhibiting inflammation in patients with poststroke VD.展开更多
Photodynamic therapy(PDT) is a clinically approved procedure for treatment of cancer and infections. PDT involves systemic or topical administration of a photosensitizer(PS), followed by irradiation of the diseased ar...Photodynamic therapy(PDT) is a clinically approved procedure for treatment of cancer and infections. PDT involves systemic or topical administration of a photosensitizer(PS), followed by irradiation of the diseased area with light of a wavelength corresponding to an absorbance band of the PS. In the presence of oxygen, a photochemical reaction is initiated, leading to the generation of reactive oxygen species and cell death. Besides causing direct cytotoxic effects on illuminated tumor cells, PDT is known to cause damage to the tumor vasculature and induce the release of pro-inflammatory molecules. Pre-clinical and clinical studies have demonstrated that PDT is capable of affecting both the innate and adaptive arms of the immune system. Immune stimulatory properties of PDT may increase its beneficial effects giving the therapy wider potential to become more extensively used in clinical practice. Be-sides stimulating tumor-specific cytotoxic T-cells capable to destroy distant untreated tumor cells, PDT leads to development of anti-tumor memory immunity that can potentially prevent the recurrence of cancer. The immunological effects of PDT make the therapy more effective also when used for treatment of bacterial infections, due to an augmented infiltration of neutrophils into the infected regions that seems to potentiate the outcome of the treatment.展开更多
AIM: To compare the efficacy and safety of photodynamic therapy(PDT) with overlapping multiple spots and single spot for treating circumscribed choroidal hemangioma. · METHODS: Twenty-two patients(22 eyes) with s...AIM: To compare the efficacy and safety of photodynamic therapy(PDT) with overlapping multiple spots and single spot for treating circumscribed choroidal hemangioma. · METHODS: Twenty-two patients(22 eyes) with symptomatic circumscribed choroidal hemangioma received PDT treatment. Fourteen patients received overlapping spots(two to three spots) PDT,whereas eight patients received single-spot PDT. Laser was used at 50J/cm2for 83s in the overlapping-spot group and 50J/cm2for 166s in the single-spot group. Clinical examination,funduscopy,fluorescein angiography,and ultrasonography were performed at baseline and after treatment. ·RESULTS: The mean follow-up time was 28.5 ±8.0 months in the overlapping-spot group and 27.0 ±5.0 months in the single-spot group. Nine patients(64.2%) had their vision improved over two lines on the Snellen chart,and five patients showed stable visual acuity in the overlapping-spot group. The mean thickness of tumor decreased from 2.7 ±0.8mm to 1.2±0.9mm,and the mean greatest tumor linear dimension decreased from 7.4 ± 1.5mm to 4.5 ±3.5mm after treatment. In the single-spot group,two patients(25%) had their vision improved over two lines on the Snellen chart,and six patients had unchanged stable vision. The mean tumor thickness in this group decreased from 2.5±0.7mm to 1.4±1.0mm,and the mean greatest tumor linear dimension decreased from 7.2±1.3mm to 4.7±3.6mm. No significant differences in visual improvement and tumor regression were found between the two groups. ·CONCLUSION:Overlapping-spotPDTunderappropriate treatment parameters and strategies is as effective andsafe as single-spot PDT for treating symptomatic circumscribed choroidal hemangioma. Improved or stabilized visual acuity was achieved as a result of tumor regression.展开更多
AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors(GI NET).METHODS In this retrospective cohort study,we used 2009-2014 data from 2 United States commercial claims databases to exa...AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors(GI NET).METHODS In this retrospective cohort study,we used 2009-2014 data from 2 United States commercial claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques.Treatments included somatostatin analogues(SSA),cytotoxic chemotherapy(CC),targeted therapy(TT),interferon(IF)and combinations.We identified patients at least 18 years of age,with≥1 inpatient or≥2 outpatient claims for GI NET who initiated pharmacologic treatment from 7/1/09-6/30/14.A 6 mo clean period prior to first treatment ensured patients were newly treated.Patients were followed until end of enrollment or the study end date,whichever was first.RESULTS We identified 2258 newly treated GI NET patients:mean(SD)age was 55.6 years(SD=9.7),47.2%of the patients were between 55 and 64 years,and 48.8%were female.All regions of the United States were represented.59.6%started first-line therapy with SSA monotherapy(964 with octreotide LAR,380 with octreotide SA,and 1 with lanreotide),33.3%CC,3.6%TT,and 0.5%IF.The remainder received combinations.Mean follow up was 576 d.Overall mean first-line therapy duration was 361 d(449 d for SSA,215 for CC,267 for TT).58.9%of patients had no pharmacological treatment beyond first line.The most common secondline was combination therapy with SSA.In graphical pattern analysis,there was no clear pattern visible after first line therapy.CONCLUSION In this study,60%of patients initiated treatment with SSA alone or in combination.The relatively long time to discontinuation suggests possible sustained effectiveness and tolerability.展开更多
Microwave ablation(MWA)is a cancer treatment method.The tumor tissue absorbs electromagnetic energy,which heats and kills it.A microwave ablation antenna plays a critical role in this process.Its radiation field must ...Microwave ablation(MWA)is a cancer treatment method.The tumor tissue absorbs electromagnetic energy,which heats and kills it.A microwave ablation antenna plays a critical role in this process.Its radiation field must completely cover the tumor but not the healthy tissue.At present,the radiation pattern of most invasive ablation antennas is spherical.However,in the clinic,the shape of some tumors may be asymmetrical or the antenna cannot be inserted into the center of the tumor for some other reason.In order to solve these problems,a directional heating antenna for microwave ablation is proposed in this paper.The proposed antenna,operating at 2.45 GHz,consists of a monopole and a reflector.The feed is given by a substrate integrated coaxial line(SICL)and coplanar waveguide(CPW).The omnidirectional radiation field of the monopole is reflected by a reflector that is extended from the outer conductors of the SICL to form a directional radiation field.The impedance matching network is designed on SICL to match the antenna to 50Ω.The antenna is fabricated using a mature printed circuit board(PCB).The reflection coefficient of the antenna in porcine liver tissue measured by a vector network analyzer shows good agreement with the simulations.Then,an ablation experiment in porcine liver is conducted with power of 10 W for 10 min,and the experimental results confirm the validity of the design.展开更多
OBJECTIVE:To examine whether color parameters of tongue inspection(TI)using a digital camera was reliable and valid,and to examine which color parameters serve as predictors of symptom patterns in terms of East Asian ...OBJECTIVE:To examine whether color parameters of tongue inspection(TI)using a digital camera was reliable and valid,and to examine which color parameters serve as predictors of symptom patterns in terms of East Asian medicine(EAM).METHODS:Two hundred female subjects'tongue substances were photographed by a mega-pixel digital camera.Together with the photographs,the subjects were asked to complete Yin deficiency,Phlegm pattern,and Cold-Heat pattern questionnaires.Using three sets of digital imaging software,each digital image was exposure-and white balance-corrected,and finally L*(luminance),a*(red-green balance),and b*(yellow-blue balance)values of the tongues werecalculated.To examine intra-and inter-rater reliabilities and criterion validity of the color analysis method,three raters were asked to calculate color parameters for 20 digital image samples.Finally,four hierarchical regression models were formed.RESULTS:Color parameters showed good or excellent reliability(0.627-0.887 for intra-class correlation coefficients)and significant criterion validity(0.523-0.718 for Spearman's correlation).In the hierarchical regression models,age was a significant predictor of Yin deficiency(β=0.192),and b*value of the tip of the tongue was a determinant predictor of Yin deficiency,Phlegm,and Heat patterns(β=-0.212,-0.172,and-0.163).Luminance(L*)was predictive of Yin deficiency(β=-0.172)and Cold(β=0.173)pattern.CONCLUSION:Our results suggest that color analysis of the tongue using the L*a*b*system is reliable and valid,and that color parameters partially serve as symptom pattern predictors in EAM practice.展开更多
The main task of cancer vaccines is to deliver tumorspecifc antigens to antigen-presenting cells for immune recognition that can lead to potent and durable immune response against treated tumor. Using photodynamic the...The main task of cancer vaccines is to deliver tumorspecifc antigens to antigen-presenting cells for immune recognition that can lead to potent and durable immune response against treated tumor. Using photodynamic therapy （PDT）-generated vaccines as an example of autologous whole-cell cancer vaccines, the importance is discussed of the expression of death-associated molecules on cancer vaccine cells. This aspect appears critical for the optimal capture of vaccine cells by host’s sentinel phagocytes in order that the tumor antigenic material is processed and presented for immune recognition and elimination of targeted malignancy. It is shown that changing death pattern of vaccine cells by agents modulating apoptosis, autophagy or necrosis can significantly alter the therapeutic impact of PDT-generated vaccines. Improved therapeutic effect was observed with inhibitors of necrosis/necroptosis using IM-54, necrostatin-1 or necrostatin-7, as well as with lethal autophagy inducer STF62247. In contrast, reduced vaccine potency was found in case of treating vaccine cells with apoptosis inhibitors or lethal autophagy inhibitor spautin-1. Therefore, PDT-generated cancer vaccine cells undergoing apoptosis or lethal autophagy are much more likely to produce therapeutic benefit than vaccine cells that are necrotic. These fndings warrant further detailed examination of the strategy using cell death modulating agents for the enhancement of the efficacy of cancer vaccines.展开更多
基金supported by 2023 Annual Public Welfare Technological Application Research Project of Jinhua City(2023年度金华市公益性技术应用研究项目,No.2023-4-256).
文摘Objective:To evaluate the clinical efficacy of umbilical herbal application combined with pestle needle therapy in the treatment of functional diarrhea(FD)due to deficient cold of the spleen and stomach.Methods:A total of 72 patients with FD were enrolled and randomly assigned to two groups using the random number table method,with 36 patients in each group.Both groups received conventional Western medication treatment.The observation group additionally received umbilical application of Wen Yang Bu Pi Gao(Yang-warming and spleenstrengthening herbal paste)combined with pestle needle therapy.After 7 d of treatment,the clinical efficacy was assessed.Traditional Chinese medicine(TCM)symptom scores,irritable bowel syndrome-quality of life(IBS-QOL)score,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group was 91.7%,which was significantly higher than 69.4%in the control group(P<0.05).After treatment,TCM symptom and IBS-QOL scores in both groups were significantly reduced compared to those before treatment(P<0.05),and the scores in the observation group were significantly lower than those in the control group(P<0.05).No adverse reactions occurred in either group during the treatment period.Conclusion:Compared to conventional Western medication treatment alone,the addition of umbilical application of Wen Yang Bu Pi Gao combined with pestle needle therapy can more effectively alleviate clinical symptoms and improve the quality of life in patients with FD due to deficient cold of the spleen and stomach.
基金Supported by Putra Grant from Universiti Putra Malaysia(No.9409800,No.9432700)
文摘AIM:To describe the prevalence and changes in treatment patterns of ranibizumab and photodynamic therapy(PDT)among retinal disease patients who attended the Ophthalmology Clinic in the tertiary care Hospital Selayang from 2010 to 2014.METHODS:Study subjects were recruited retrospectively using the Electronic Medical Record(EMR)database software in Hospital Selayang.Demographic data,medical history,diagnostic procedure,treatments and diagnosis of patients were recorded.RESULTS:The five-year analysis included 821 patients with a mean age of 65.9±11.73 y.Overall,there were a highernumber of males(63.1%)and a higher number of Chinese(47.4%)patients.Among the 821 patients,62.9%received ranibizumab injection followed by 19.2%PDT therapy and 17.9%had ranibizumab combined with PDT therapy.Age-related macular degeneration(AMD)and polypoidal choroidal vasculopathy(PCV)were the most common retinal eye diseases reported,recording prevalence of 25.0%and 45.6%,respectively.The trend in ranibizumab treatment was reported to increase while PDT showed a decrease in trend from year 2010 to 2014.In terms of treatment,following multiple logistic regression,AMD was associated with the subjects being more likely to have received ranibizumab monotherapy(P〈0.001)while PCV was associated with more likely to have received PDT(P〈0.001)and PDT combined with ranibizumab therapy(P〈0.001).CONCLUSION:The tertiary care setting in Malaysia is consistent with management of patients from other countries whereby ranibizumab is the most common treatment given to patients with AMD,while PCV patients most commonly receive PDT and ranibizumab combined with PDT therapy.
基金the Committee on Chinese Medicine and Pharmacy,Ministry of Health and Welfare,Taiwan Traditional Chinese Medicine Diagnosis of Patients with Cancer Receiving Chemotherapy:Based on Meridian Energy Results(First Year),No.CCMP98-RD-034Traditional Chinese Medicine Diagnosis of Patients With Cancer Receiving Chemotherapy:Based on Meridian Energy Results(Second Year),No.CCMP99-RD-106Construction of Care Model of Integrative Medicine for Patients With Cancer,No.CCMP100-RD-026
文摘OBJECTIVE: Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and healthrelated quality of life(HRQOL) are common diagnostic measures for cancer patients, the association between them has not been studied. This study aimed to describe the changes in the pattern of symptoms of Yang-deficiency, Yin-deficiency, blood stasis, and HRQOL before and after chemotherapy,and to examine the association between the patterns and the cancer patients' HRQOL.METHODS: A panel study was undertaken with 123 cancer patients who were about to begin their first course of chemotherapy at four teaching hospitals in Taiwan. A structured questionnaire was used before and after chemotherapy. HRQOL was assessed using the Medical Outcomes Survey Short-Form 36. The Traditional Chinese Medical Constitutional Scale was used to measure Yang-deficiency, Yin-deficiency, and blood stasis patterns,with higher scores indicating a larger deficiency.RESULTS: The patients had significantly worse scores for Yang-deficient pattern, Yin-deficiency pattern, blood stasis pattern, and the physical components of HRQOL after chemotherapy compared with before chemotherapy. The HRQOL scores correlated significantly with Yang-deficiency, Yin-deficiency, and the blood stasis pattern scores. A generalized estimating equation model showed that the HRQOL scores were significantly worse after chemotherapy compared with before chemotherapy for the physical component, but not for the mental component. Blood stasis pattern was significantly associated with a decreased HRQOL in both the physical and mental components. A hemoglobin level < 12 g/d L was associated with a worse physical component of HRQOL.CONCLUSION: The Yang-deficiency, Yin-deficiency,and blood stasis patterns were all associated with lower HRQOLincancerpatientsafterchemotherapy.
文摘Introduction: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the third leading cause of cancer deaths in the United States. The goal of this study was to understand treatment patterns, biomarker testing practices, treatment adherence, and the clinical and economic outcomes associated with chemotherapy for metastatic disease. Methods and Materials: We retrospectively examined electronic health records of patients with metastatic CRC who initiated chemotherapy between 01 January 2007 and 30 June 2011, with follow-up to 30 June 2012. Parameters analyzed included demographics and clinical characteristics, treatment patterns, clinical outcomes, and health care resource utilization. Results: In the analysis, 756 patients were included;median age was 61 years (55% male) at start of first line therapy. The most commonly used regimens in the first, second, and third line were FOLFOX + bevacizumab (46%), FOLFIRI + bevacizumab (23%), and irinotecan + cetuximab (23%) respectively. Adherence to guidelines decreased with increasing line of therapy. When assessed by treatment backbone categories in the third line, outcome measures including overall survival (OS), and time to treatment discontinuation (TTD) were not statistically different between groups. In the multivariable model, body mass index (BMI), performance status, and KRAS were significant predictors of survival. Conclusions: This study provides insight into patterns of care and outcomes of mCRC patients for the aforementioned time period. As treatment options for mCRC evolve, it is valuable to understand the continuum of care to help inform future treatment among candidates for continued therapy.
基金supported by the Major Science and Technology Special Projects in Henan Province(No.221100310100)co-construction Project of Henan Medical Science and Technology(LHGJ20230286).
文摘Cerenkov radiation(CR)can serve as a source of internal light to overcome the limited tissue penetration of external light in conventional photodynamic therapy(PDT).However,insufficient luminescence intensity hinders the clinical application of CR-PDT.Here,we developed a glutathione-responsive biomimetic nanoplatform by fusing cancer cell membranes and liposomes loaded with photosensitizer hematoporphyrin monomethyl ether(HMME)and a radiation energy amplifier Eu^(3+),named HMME-Eu@LEV.Colloidal Eu^(3+)convertsγ-radiation and CR from radioisotopes into fluorescence to enhance antitumor effects.Sequential administration ensures co-localization of HMME-Eu@LEV and radiopharmaceutical^(18)F-fluorodeoxyglucose(FDG)at the tumor site,triggering enhanced CR-PDT and immunogenic cell death.Our observations indicated that luminescence resonance energy transfer between Eu^(3+)and HMME was efficient,and Cerenkov luminescence from Eu@LEV+FDG was approximately 5.6-fold higher in intensity than that from FDG alone.As a result,abundant ROS were generated,and macrophages in the tumor microenvironment were polarized from M2 to M1.In addition,the immunosuppressive tumor microenvironment could be reversed by promoting the maturation of dendritic cells and infiltration of cytotoxic T lymphocytes.The activated immune system effectively inhibited the growth of primary tumors and spread of distant metastases.Our work demonstrates the feasibility of CR-PDT without an external light source and the critical role of nanomaterials in personalized medicine.
基金supported by the Research and Innovation Fund of Shandong University of Traditional Chinese Medicine(2018-220315).
文摘Objective To investigate three representative conditions,gallbladder colic,renal colic,and primary dysmenorrhea,to identify trends and regularities in acupoint selection and provide evidence-based references for clinical practice.Methods Clinical studies on acupuncture for gallbladder colic,renal colic,and primary dysmenorrhea published between 2006 and 2025 were retrieved from the Chinese National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Wanfang,and PubMed.Bibliometric analysis was performed using IBM SPSS Modeler 18.0,and the Apriori algorithm was applied to evaluate acupoint-use patterns.Results The analysis demonstrated that commonly selected acupoints for these conditions have remained relatively consistent over the past two decades.Frequently used acupoints for gallbladder colic included Yanglingquan(GB 34),Dannang(EX-LE 6),Qiuxu(GB 40),Taichong(LR 3),Danshu(BL 19),Zusanli(ST 36),Qimen(LR 14),Riyue(GB 24),and Ganshu(BL 18).For renal colic,the most frequently reported points were Shenshu(BL 23),Sanyinjiao(SP 6),Zusanli(ST 36),Yinlingquan(SP 9),Jingmen(GB 25),Guanyuan(CV 4),Ashi points,Zhongji(CV 3),and Pangguangshu(BL 28).The main acupoints for primary dysmenorrhea were Sanyinjiao(SP 6),Guanyuan(CV 4),Ciliao(BL 32),Diji(SP 8),Shiqizhui(EX-B 8),Zhongji(CV 3),Zusanli(ST 36),Zigong(EX-CA 1),and Qihai(CV 6).On average,treatment protocols employed 3-4 acupoints per session.Conclusions The most frequently selected acupoints for visceral smooth muscle spasmodic pain were located within the ganglion segment innervation areas,showing close association with the target organs.Furthermore,treatment protocols typically involved a small number of acupoints.These findings highlight the need for further systematic research,particularly randomized controlled trials,to validate and strengthen the evidence base.
基金supported by the Research Cultivation Project of Beijing Municipal Hospital(北京市属医院科研培育课题,No.PZ2022015).
文摘Objective:To observe the efficacy of acupuncture combined with traditional Chinese herbs in the treatment of poststroke vascular dementia(VD)and the effects on serum interleukin(IL)-6 and superoxide dismutase(SOD).Methods:A total of 240 patients with poststroke VD were selected and randomly divided into two groups according to the random number table method,with 120 cases in each group.Both groups received Hua Tan Tong Luo(phlegmresolving and collateral-activating)formula,once daily;the observation group was additionally treated with Yi Shen Tiao Du(kidney-tonifying and Governor Vessel-regulating)acupuncture once daily for 6 consecutive days,followed by 1 d of rest.Both groups were treated for 15 d as one course,for a total of 2 courses.After treatment,the total effective rate was compared.Changes in scores of traditional Chinese medicine(TCM)symptoms,clinical dementia rating(CDR),National Institutes of Health stroke scale(NIHSS),and Chinese version of mini-mental state examination(MMSE),and serum levels of IL-6 and SOD were observed in both groups.Results:The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,TCM symptom,CDR,and NIHSS scores,and serum IL-6 levels in both groups were lower than those before treatment(P<0.05),while MMSE scores and serum SOD levels were higher than those before treatment(P<0.05).After treatment,the observation group showed lower TCM symptom,CDR,and NIHSS scores,and serum IL-6 levels than the control group(P<0.05),and higher MMSE scores and serum SOD levels than the control group(P<0.05).Conclusion:Compared to Hua Tan Tong Luo formula alone,Yi Shen Tiao Du acupuncture combined with Hua Tan Tong Luo formula demonstrates better efficacy in reducing dementia severity,improving cognitive and neurological function,and inhibiting inflammation in patients with poststroke VD.
基金Supported by United States National Institute of Health grant AI050875the Ph D program of the Medical University of Graz,Austria
文摘Photodynamic therapy(PDT) is a clinically approved procedure for treatment of cancer and infections. PDT involves systemic or topical administration of a photosensitizer(PS), followed by irradiation of the diseased area with light of a wavelength corresponding to an absorbance band of the PS. In the presence of oxygen, a photochemical reaction is initiated, leading to the generation of reactive oxygen species and cell death. Besides causing direct cytotoxic effects on illuminated tumor cells, PDT is known to cause damage to the tumor vasculature and induce the release of pro-inflammatory molecules. Pre-clinical and clinical studies have demonstrated that PDT is capable of affecting both the innate and adaptive arms of the immune system. Immune stimulatory properties of PDT may increase its beneficial effects giving the therapy wider potential to become more extensively used in clinical practice. Be-sides stimulating tumor-specific cytotoxic T-cells capable to destroy distant untreated tumor cells, PDT leads to development of anti-tumor memory immunity that can potentially prevent the recurrence of cancer. The immunological effects of PDT make the therapy more effective also when used for treatment of bacterial infections, due to an augmented infiltration of neutrophils into the infected regions that seems to potentiate the outcome of the treatment.
基金Supported by the Zhejiang Medical Science Research Foundation of China(No.2009A108)Zhejiang Key Innovation Team Project of China(No.2011R09039-02)Zhejiang Key Laboratory Fund of China(No.2011E10006)
文摘AIM: To compare the efficacy and safety of photodynamic therapy(PDT) with overlapping multiple spots and single spot for treating circumscribed choroidal hemangioma. · METHODS: Twenty-two patients(22 eyes) with symptomatic circumscribed choroidal hemangioma received PDT treatment. Fourteen patients received overlapping spots(two to three spots) PDT,whereas eight patients received single-spot PDT. Laser was used at 50J/cm2for 83s in the overlapping-spot group and 50J/cm2for 166s in the single-spot group. Clinical examination,funduscopy,fluorescein angiography,and ultrasonography were performed at baseline and after treatment. ·RESULTS: The mean follow-up time was 28.5 ±8.0 months in the overlapping-spot group and 27.0 ±5.0 months in the single-spot group. Nine patients(64.2%) had their vision improved over two lines on the Snellen chart,and five patients showed stable visual acuity in the overlapping-spot group. The mean thickness of tumor decreased from 2.7 ±0.8mm to 1.2±0.9mm,and the mean greatest tumor linear dimension decreased from 7.4 ± 1.5mm to 4.5 ±3.5mm after treatment. In the single-spot group,two patients(25%) had their vision improved over two lines on the Snellen chart,and six patients had unchanged stable vision. The mean tumor thickness in this group decreased from 2.5±0.7mm to 1.4±1.0mm,and the mean greatest tumor linear dimension decreased from 7.2±1.3mm to 4.7±3.6mm. No significant differences in visual improvement and tumor regression were found between the two groups. ·CONCLUSION:Overlapping-spotPDTunderappropriate treatment parameters and strategies is as effective andsafe as single-spot PDT for treating symptomatic circumscribed choroidal hemangioma. Improved or stabilized visual acuity was achieved as a result of tumor regression.
基金Supported by Novartis Pharmaceuticals,One Health Plaza,East Hanover,No.NJ 07936-1080,United State
文摘AIM To describe real-world treatment patterns of gastrointestinal neuroendocrine tumors(GI NET).METHODS In this retrospective cohort study,we used 2009-2014 data from 2 United States commercial claims databases to examine newly pharmacologically treated patients using tabular and graphical techniques.Treatments included somatostatin analogues(SSA),cytotoxic chemotherapy(CC),targeted therapy(TT),interferon(IF)and combinations.We identified patients at least 18 years of age,with≥1 inpatient or≥2 outpatient claims for GI NET who initiated pharmacologic treatment from 7/1/09-6/30/14.A 6 mo clean period prior to first treatment ensured patients were newly treated.Patients were followed until end of enrollment or the study end date,whichever was first.RESULTS We identified 2258 newly treated GI NET patients:mean(SD)age was 55.6 years(SD=9.7),47.2%of the patients were between 55 and 64 years,and 48.8%were female.All regions of the United States were represented.59.6%started first-line therapy with SSA monotherapy(964 with octreotide LAR,380 with octreotide SA,and 1 with lanreotide),33.3%CC,3.6%TT,and 0.5%IF.The remainder received combinations.Mean follow up was 576 d.Overall mean first-line therapy duration was 361 d(449 d for SSA,215 for CC,267 for TT).58.9%of patients had no pharmacological treatment beyond first line.The most common secondline was combination therapy with SSA.In graphical pattern analysis,there was no clear pattern visible after first line therapy.CONCLUSION In this study,60%of patients initiated treatment with SSA alone or in combination.The relatively long time to discontinuation suggests possible sustained effectiveness and tolerability.
基金Project supported by the National Natural Science Foundation of China(Grant No.U1966201)the Fundamental Research Funds for the Central Universities,China(Grant No.A03019023801224)。
文摘Microwave ablation(MWA)is a cancer treatment method.The tumor tissue absorbs electromagnetic energy,which heats and kills it.A microwave ablation antenna plays a critical role in this process.Its radiation field must completely cover the tumor but not the healthy tissue.At present,the radiation pattern of most invasive ablation antennas is spherical.However,in the clinic,the shape of some tumors may be asymmetrical or the antenna cannot be inserted into the center of the tumor for some other reason.In order to solve these problems,a directional heating antenna for microwave ablation is proposed in this paper.The proposed antenna,operating at 2.45 GHz,consists of a monopole and a reflector.The feed is given by a substrate integrated coaxial line(SICL)and coplanar waveguide(CPW).The omnidirectional radiation field of the monopole is reflected by a reflector that is extended from the outer conductors of the SICL to form a directional radiation field.The impedance matching network is designed on SICL to match the antenna to 50Ω.The antenna is fabricated using a mature printed circuit board(PCB).The reflection coefficient of the antenna in porcine liver tissue measured by a vector network analyzer shows good agreement with the simulations.Then,an ablation experiment in porcine liver is conducted with power of 10 W for 10 min,and the experimental results confirm the validity of the design.
文摘OBJECTIVE:To examine whether color parameters of tongue inspection(TI)using a digital camera was reliable and valid,and to examine which color parameters serve as predictors of symptom patterns in terms of East Asian medicine(EAM).METHODS:Two hundred female subjects'tongue substances were photographed by a mega-pixel digital camera.Together with the photographs,the subjects were asked to complete Yin deficiency,Phlegm pattern,and Cold-Heat pattern questionnaires.Using three sets of digital imaging software,each digital image was exposure-and white balance-corrected,and finally L*(luminance),a*(red-green balance),and b*(yellow-blue balance)values of the tongues werecalculated.To examine intra-and inter-rater reliabilities and criterion validity of the color analysis method,three raters were asked to calculate color parameters for 20 digital image samples.Finally,four hierarchical regression models were formed.RESULTS:Color parameters showed good or excellent reliability(0.627-0.887 for intra-class correlation coefficients)and significant criterion validity(0.523-0.718 for Spearman's correlation).In the hierarchical regression models,age was a significant predictor of Yin deficiency(β=0.192),and b*value of the tip of the tongue was a determinant predictor of Yin deficiency,Phlegm,and Heat patterns(β=-0.212,-0.172,and-0.163).Luminance(L*)was predictive of Yin deficiency(β=-0.172)and Cold(β=0.173)pattern.CONCLUSION:Our results suggest that color analysis of the tongue using the L*a*b*system is reliable and valid,and that color parameters partially serve as symptom pattern predictors in EAM practice.
基金Supported by The Canadian Cancer SocietyNo.#701132
文摘The main task of cancer vaccines is to deliver tumorspecifc antigens to antigen-presenting cells for immune recognition that can lead to potent and durable immune response against treated tumor. Using photodynamic therapy （PDT）-generated vaccines as an example of autologous whole-cell cancer vaccines, the importance is discussed of the expression of death-associated molecules on cancer vaccine cells. This aspect appears critical for the optimal capture of vaccine cells by host’s sentinel phagocytes in order that the tumor antigenic material is processed and presented for immune recognition and elimination of targeted malignancy. It is shown that changing death pattern of vaccine cells by agents modulating apoptosis, autophagy or necrosis can significantly alter the therapeutic impact of PDT-generated vaccines. Improved therapeutic effect was observed with inhibitors of necrosis/necroptosis using IM-54, necrostatin-1 or necrostatin-7, as well as with lethal autophagy inducer STF62247. In contrast, reduced vaccine potency was found in case of treating vaccine cells with apoptosis inhibitors or lethal autophagy inhibitor spautin-1. Therefore, PDT-generated cancer vaccine cells undergoing apoptosis or lethal autophagy are much more likely to produce therapeutic benefit than vaccine cells that are necrotic. These fndings warrant further detailed examination of the strategy using cell death modulating agents for the enhancement of the efficacy of cancer vaccines.
