Traditional Chinese medicine (TCM) has some unique advantages in the prevention and treatment of cancer. Due to different ideas and mechanism of between TCM and biomedicine in the prevention and treatment of cancer, the clinial effect evaluation approches of biomedicine could not be used as a beneficial method to scientifically evaluate the effects of TCM. From three angles, this article analyzes the key issues regardsing the evaluation methods of TCM as an adjuvant therapy of cancer. It draws lessons from the idea of quality-adjusted survival (QAS), proposes Two-in-One (TIO) method to evaluate the effects of TCM as adjuvant therapy of cancer, which reflects the combined value of the individual patient dynamic information and provides methodological support for the effect evaluation of TCM.
ObjectiveTo investigate the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) in obstructive jaundice of elderly patients. MethodsTotally 338 patients with obstructive jaundice underwent ERCP were divided into elderly group (age ≥60 years old) and nonelderly group (age lt;60 years old) based on age. The levels of serum amylase (AMY), ALT, and TBIL in 6, 24, and 48 h after ERCP were detected. The success rate of cholangiopancreatography, accuracy rate of diagnosis, and incidence of complications after ERCP in two groups were analyzed. ResultsThe difference of serum AMY, ALT, and TBIL levels of patients in 6, 24, and 48 h after ERCP were not significant between two groups (Pgt;0.05). The success rate of cholangiopancreatography in nonelderly group was 96.3% (130/135) and in elderly group was 96.1% (195/203), and no difference was found (Pgt;0.05). However, the accuracy rate of diagnosis of ERCP in nonelderly group (84.6%, 110/130) was significantly lower than that in elderly group (98.5%, 192/195), Plt;0.05. The difference of the incidence of complications was not significant between two groups 〔14.8% (20/135) vs. 17.2% (35/203)〕, Pgt;0.05. There was no mortality in two groups patients. ConclusionERCP is a safe, effective, and accurate method, which is of importance to the diagnosis of obstructive jaundice in elderly patients.
Objective To investigate the differences between six parts of China in prediction models of lung function.Methods The predicted values of 360 healthy volunteers underwent pulmonary functiontest in east China were compared with that of north China, northeast China, northwest China, southwest China, south China and Asian American. Results In the male group, the prediction values of east China were as follows: VC ( 4. 19 ±0. 33) L, coefficient correlation( r) to the other five regions were 0. 803-0. 983,the differences to the other five regions were 1. 90% -4. 30% ; FVC ( 4. 06 ±0. 35) L, r to the others were 0. 912-0. 981, the differences to the other four regions were 0-2. 46% except for south China of 8. 10% , to Asian American ×0. 88 and Asian American ×0. 94 were 1. 97% and 4. 68% ; FEV1 ( 3. 34 ±0. 40) L, r to the others were 0. 963-0. 992, the differences to north China and east China were 0. 9% and 3. 59% , to southwest China and south China were gt;5% , to Asian American ×0. 88 and Asian American×0. 94 were 6. 89% and 0. 6% ; FEV1 /FVC ( 80. 87 ±3. 84) % , r to the others were 0. 989-0. 999, the differences to north China, northeast China and south China were 0. 42% -3. 04% , to the others were gt;5% . In the female group, the prediction values of east China were as follows: VC ( 3. 00 ±0. 33) L, r to the other five regions were 0. 899-0. 993, the differences to the other five regions were 0. 33% -3. 67% ; FVC( 2. 92 ±0. 34) L, r to the other five regions were 0. 929-0. 990, the differences to the other five regions were 1. 02% -2. 40%, to Asian American ×0. 88 and Asian American ×0. 94 were 4. 79% and 6. 16% ; FEV1 ( 2. 38 ±0. 39) L, r to the other five regions were 0. 958-0. 994, the differences to northeast China, southwest China, south China were 0. 84% -3. 36% , to north china was 7. 19% , to Asian American ×0. 88 and Asian American ×0. 94 were 2. 10% and 4. 62% ; FEV1 /FVC ( 82. 04 ±3. 94) % , r to the others were 0. 991-1. 000, the differences to the other four regions were 1. 34% -4. 55% except for southwest China was 7. 59% . Conclusions VC and FVC predicted values are coincident between six parts of China. FEV1 /FVC predicted values are coincident in the four parts of China except for westnorth and westsouth China. FEV1 predicted values are different. The oversea predicted values should be used with appropriate conversion factors.
Objective To compare canine decel luarized venous valve stent combining endothel ial progenitor cells (EPC) with native venous valve in terms of venous valve closure mechanism in normal physiological conditions. Methods Thirty-six male hybrid dogs weighing 15-18 kg were used. The left femoral vein with valve from 12 dogs was harvested to prepare decelluarized valved venous stent combined with EPC. The rest 24 dogs were randomly divided into the experimental group and the control group (n=12 per group). In the experimental group, EPC obtained from the bone marrowthrough in vitro ampl ification were cultured, the cells at passage 3 (5 × 106 cells/mL) were seeded on the stent, and the general and HE staining observations were performed before and after the seeding of the cells. In the experimental group, allogenic decelluarized valved venous stent combined with EPC was transplanted to the left femoral vein region, while in the control group, the autogenous vein venous valve was implanted in situ. Color Doppler Ultrasound exam was performed 4 weeks after transplantation to compare the direction and velocity of blood flow in the distal and proximal end of the valve, and the changes of vein diameter in the valve sinus before and after the closure of venous valve when the dogs changed from supine position to reverse trendelenburg position. Results General and HE staining observations before and after cell seeding: the decelluarized valved venous stent maintained its fiber and collagen structure, and the EPC were planted on the decelluarized stent successfully through bioreactor. During the period from the reverse trendelenburg position to the starting point for the closure of the valve, the reverse flow of blood occurred in the experimental group with the velocity of (1.4 ± 0.3) cm/s; while in the control group, there was no reverse flow of blood, but the peak flow rate was decreased from (21.3 ± 2.1) cm/s to (18.2 ± 3.3) cm/s. In the control group, the active period of valve, the starting point for the closure of the valve, and the time between the beginning of closure and the complete closure was (918 ± 46), (712 ± 48), and (154 ± 29) ms, respectively; while in the experimental group, it was (989 ± 53), (785 ± 43), and (223 ± 29) ms, respectively. There was significant difference between two groups (P lt; 0.05).After the complete closure of valve, no reverse flow of blood occurred in two groups. The vein diameter in the valve sinus of the experimental and the control group after the valve closure was increased by 116.8% ± 2.0% and 118.5% ± 2.2%, respectively, when compared with the value before valve closure (P gt; 0.05). Conclusion Canine decelluarized venous valve stent combined with EPC is remarkably different from natural venous valve in terms of the valve closure mechanism in physiological condition. The former rel ies on the reverse flow of blood and the latter is related to the decreased velocity of blood flow and the increased pressure of vein in the venous sinus segment.
Objective To evaluate the diagnosis of blue-on-yellow perimetry and macular threshold perimetry in early primary glaucoma. Methods Humphrey II 750 automatic perimetry was used to test 60 eyes of 60 cases in normal control group and 63 eyes of 63 cases in early primary glaucoma group with white-on-white perimetry (W/W), blue-on-yellow perimetry (B/Y)，and macular threshold perimetry (M TP). The results of the visual field defects detected by the three perimetries were compared and analyzed.Results The differences of mean sensibility of W/W, B/Y and MTP between the two groups had statistical significance［t=-3 .01, P=0.0054 (W/W); t=-2.95, P=0.006 3 (B/Y); t=-2.59,P=0. 0150 (MTP)］. In the diagnosis of early primary glaucoma, the sensitivity of MTP was the highest (83%), B/Y was the second (65%), and W/W was the lowest (48%). When B/Y and MTP were combined, the sensitivity was improved to 94% using parallel testing, and the specificity was improved to 87% using serial testing.Conclusions B/Y and MTP are valuable in diagnosis of early primary glaucoma, and the sensitivity and specificity of the diagnosis can be improved when B/Y and MTP are combined. (Chin J Ocul Fundus Dis，2003，19：102-105)
ObjectiveTo probe the classification of diabetic retinopathy (DR) and the different grade of diabetic and type of macular edema according to fundus fluorescein angiography (FFA). MethodsFFA was performed on 1 058 patients (2 097 eyes) to classify DR and macular edema with the analysis of duration of DM, visual acuity, manifestation of FFA images and results of ophthalmoscopic examination.ResultsIn 2 097 eyes, there were 124 (5.9%) without DR, 396 (18.9%) with DR I, 430 (20.5%) with DR II, 563 (26.8%) with DR III, 262 (125%) with preproliferative diabetic retinopathy (PPDR), 254 (12.%) with DR IV, 60 (2.9%) with DR V, and 8 (0.4%) with DR VI. In 2 097 eyes there were 819 (39.1%) with macular edema, including 311 (38%) with focal macular edema, 322 (39.3%) with diffused macular edema, 112 (13.7%) with cystoid macular edema, 25 (3.1%) with ischemia macular edema, and 49 (6.0%) with proliferative macular edema.ConclusionWith the analysis of the results of FFA of 2 097 eyes, we classify DR in stage Ⅰ (primary stage Ⅰ and Ⅱ), Ⅱ (primary stage Ⅲ), Ⅲ (preproliferative diabetic retinopathy), Ⅳ,Ⅴ, and Ⅵ; classify macular edema of DR in focal, diffused, cystoid, ischemic, and proliferating ones.(Chin J Ocul Fundus Dis, 2003,19:333-337)
Objective To study the significance of detection the short-term fluctuation (SF) of macular light threshold detected by Octopus-123 automatic perimeter in suspected early age-related macular dege-neration (AMD). Methods SF of macular light sensitivity, Amsler chart and central visual acuity were examined in 51 patients(66 eyes) with suspected early AMD group and in 32 patients (40 eyes) in the control group. Results SF were significantly different in suspected early AMD group and control group. SF was more sensitive than the examination of central visual acuity and Amsler chart. SF was related to the quantity, location and quality of drusen. Conclusion Visual function of some suspected early AMD patients with drusen may be damaged, though the central visual acuity appears normal. (Chin J Ocul Fundus Dis, 2002, 18: 119-120)
Objective To evaluate the application of tendency-oriented perimetry (TOP) in detecting the visual function of glaucoma. Methods The traditional threshold perimetry (Normal/Normal strategy) and TOP (TOP/Normal strategy) carried out by Octopus 101 perimetry were used to examine the visual field of 20 normal subjects (20 eyes), 32 cases (32 eyes) of primary open-angle glaucoma (POAG), and 14 cases (14 eyes) of suspected POAG, respectively. The visual field outcomes, indices, point by point threshold variability and defective points of the two perimetries were compared and analysed. Results The negative rate of TOP was 90% in normal subjects. The positive rate of TOP was 75% in POAG , and 100% in middle and late stage of POAG. The visual field indices of two perimetries were positively correlated, with mean sensitivity (MS) of r=0.9335, mean defect (MD) of r=0.9189, and loss variance (LV) of r=0.9621. The point by point threshold variability and defective points of TOP were higher than those of traditional threshold perimetry, but the difference between the two perimetries was not significant (P=0.2019, P=0.4448). Conclusion The visual field indices of TOP and traditional threshold perimetry are positively correlated. The sensitivity and reproducibility of TOP are high in detecting the visual function of middle and late stage of POAG. (Chin J Ocul Fundus,Dis, 2002, 18: 269-272)
Objective To evaluate the variability of four parameters of multi-focal electroretinogram (mERG) a-wave amplitude, b-wave amplitude, awave latent period, b-wave latent period. Methods Sixty normal eyes of 46 volunteers were divided into 3 groups of different ages. RETIscan 3-12 system was used to carry out mERG examination. The stimulus matrix of 61 hexagonal elements spanning the central 24deg;of the visual field. These hexons were scaled with eccentricity and divide d into 5 rings. First-order kernel was selected. Results The variability of four parameters of mERG was great. The variability of b-wave latent period was the smallest, its coefficient of variatian was 4.52%～15.62%；that of a-wave latent period held the second place:10.29%~48.67%；that of b-wave amplitude was greater:25.92%~76.11%；that of a-wave amplitude was the greatest:43.82%~88.23%. The results of three groups showed that b-wave amplitude of ring 1 had the smallest variability. Conclusions The variability of latent period is smaller than that of amplitude; the variability of b-wave was smaller than that of a-wave. The longer the centrifugal distance, the lower the amplitude density of a-wave and b-wave. Physiological and anatomical factors might be important for the variability of parameters of multi-focal electroretinogram. (Chin J Ocul Fundus Dis, 2001,17:277-279)
Objective To assess the quality of current domestic literature about enzyme-linked immunosorbent assay (ELISA) for invasive aspergillosis diagnosis by detecting Aspergillus galactomannan (GM) antigen, and to analyze the sources of bias and variability, as well as the diagnostic ability of different thresholds. Methods Both computer-based online search and manual retrieval were employed to identify relevant articles. The statistical information and quality of science were assessed and classified. The data were analyzed using Meta Disc 1.4 software. The best cutoff value for defining a positive test result was selected by summarizing the following statistical indicators as sensitivity, specificity, likelihood ratio (LR) and summary receiver operating characteristic curve (SROC curve), and by calculating the area under the curve (AUC) as well. Results A total of 20 studies among 2658 literatures were included in accordance with the inclusion criteria, and were divided into different groups based on different cutoff values. Though heterogeneity tests showed no threshold effect, and there were other reasons of heterogeneity. So the data were analyzed by random effects model. The results showed that, compared with other groups, the one with cutoff value set at 0.7 (AUC=0.9456, Q= 0.884 6) showed the best accuracy in diagnosing. Conclusion ELISA detection of Aspergillus GM antigen with cutoff value set at 0.7 has important significance in the early diagnosis of invasive aspergillosis, and it can be conducive to reduce mortality in patients at high risk for Aspergillus infection.