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POEMS syndrome is a rare clonal plasma cell disease associated with multisystem involvement. We reported a case of 48-year-old woman with large volume of exudative ascites with an increased level of λ-light chain and hepatosplenomegaly. The patient was treated with thalidomide and dexamethasone and showed a good clinical response.
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Objective: To investigate the effect of Fu Yan Qing prescription on sequelae of pelvic inflammatory disease of accumulation of dampness heat and blood stasis type. Methods: Total 80 patients with sequelae of sequelae of pelvic inflammatory disease of accumulation of dampness heat and blood stasis type were admitted to Baoding No.1 Central Hospital from December, 2018 to April, 2020 and divided into two groups according to the random number table, with 40 cases in each group. Patients in the control group were treated with conventional western medicine, while patients in the observation group were treated with Fu Yan Qing prescription orally. The clinical efficacy, the changes of traditional Chinese medicine (TCM) syndromes, local sign scores, visual analog scale (VAS) of pain, pelvic mass size, pelvic fluid volume and uterine blood flow parameters of the two groups before and after treatment were observed and compared, and the safety of the two groups was evaluated. Results: The total efficacy after treatment in the observation group was 87.5%, which was significantly higher than that of 67.5% in the control group (p<0.05). The TCM syndrome scores, local signs scores, pain scores, size of pelvic mass and pelvic effusion in both groups decreased significantly after treatment (p<0.05), PSV indexes of the two groups were significantly increased after treatment (p<0.05), and these changes were even more pronounced in the observation group (p<0.05). Compared with before treatment, PI and RI indexes of the observation group were significantly decreased after treatment (p<0.05). The observation group experienced an adverse reaction in 7.5% cases considerably lower than the 27.5% of the control group (p<0.05). Conclusion: Fu Yan Qing prescription is a safe and reliable treatment for patients with sequelae of pelvic inflammatory disease of accumulation of dampness heat and blood stasis type. It is worth promotion in clinical practice.
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BACKGROUND: Female genital tuberculosis (FGTB) is one of the major causes of infertility. However, nonspecific manifestations and the lack of easy access to gold-standard diagnostic test render a diagnostic difficult for FGTB. The objective of this study was to determine T-SPOT.TB (an interferon-γ release assay, IGRA) performance in patients with FGTB. METHODS: A total of 213 female patients with validated T-SPOT.TB results were recruited in this retrospective study. Among which, 103 were confirmed FGTB, and 110 were excluded from tuberculosis (control). Of the confirmed FGTB patients, 52 were confirmed by microbiologically/histopathologically examination, while the remaining 51 were clinically confirmed (successfully responsive to anti-tuberculosis treatment). T-SPOT.TB test was performed in both FGTB and control group during the diagnostic procedure. RESULTS: The overall sensitivity and specificity of T-SPOT.TB were 86.41% and 75.45% respectively. Sensitivity of T-SPOT.TB was significantly higher when compared with conventional tuberculosis diagnostic tests. Moreover, T-SPOT.TB test using pelvic effusion (PE) showed higher sensitivity than using corresponding peripheral blood (PB) (94.44% vs 72.22%, P < 0.001). Mean value of spot forming cells (SFCs) of T-SPOT.TB using PE was significantly higher than that of PB in FGTB group (193 (IQR 105-280) SFCs/2.5 × 105 PEMCs vs 71 (IQR 36-107) SFCs/2.5 × 105 PBMCs, P = 0.01), while this was not detected in control group (11 (IQR 0-22) SFCs/2.5 × 105 PEMCs vs 9 (IQR 0-18) SFCs/2.5 × 105 PBMCs, P = 0.77). CONCLUSION: These results demonstrated that T-SPOT.TB, especially PE T-SPOT.TB, is an useful adjunct in FGTB diagnosis.
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Ensayos de Liberación de Interferón gamma/métodos , Ensayos de Liberación de Interferón gamma/normas , Tuberculosis de los Genitales Femeninos/diagnóstico , Adulto , China , Femenino , Humanos , Leucocitos Mononucleares/inmunología , Curva ROC , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: To evaluate the performance of computed tomography (CT) as a diagnostic aid to differentiate between ruptured ovarian corpus luteal cyst (ROCLC) and ruptured ectopic pregnancy with hemorrhage (REPWH). METHODS: A total of 36 patients treated at our hospitals for ROCLC and REPWH from June 2014 to August 2017 were included in this study. Based on the diagnosis, the study population was divided into ROCLC group (n = 21) and REPWH group (n = 15). CT scans were performed for all patients prior to treatment. The size of the cystic shadows and the depth of the pelvic effusion were analyzed and compared with independent sample Student's t test and Fisher's exact test. RESULTS: Cystic shadows with maximum diameters ≥3.0 cm presented in 16 patients with ROCLC and 1 patient with REPWH, while 4 patients with ROCLC and 9 patients with REPWH exhibited cystic shadows with maximum diameters <3.0 cm. The mean diameters along the major and minor axes in the two groups were 3.76 ± 1.11 cm and 2.93 ± 0.98 cm, 1.96 ± 0.65 cm and 1.60 ± 0.55 cm, respectively (p < 0.001). The mean depth of the pelvic effusion in patients with ROCLC and REPWH were 5.20 ± 2.47 cm and 6.96 ± 2.07 cm, respectively (p = 0.038). CONCLUSION: The cystic shadow of ROCLC is larger than that of the REPWH. The depth of the pelvic effusion of REPWH is deeper than that of the ROCLC. CT can help differentiate between ROCLC and REPWH based on the size of the cystic shadow and the depth of pelvic effusion in the adnexal area.
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Hemorragia/diagnóstico , Hemorragia/etiología , Quistes Ováricos/diagnóstico por imagen , Quistes Ováricos/patología , Embarazo Ectópico/diagnóstico por imagen , Embarazo Ectópico/patología , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Embarazo , Rotura , Adulto JovenRESUMEN
Objective To analyze the clinical value of Guizhi Fuling capsules combined with fosfomycin trometamol power in the treatment of pelvic inflammatory disease and pelvic effusion.Methods A total of 60 patients with pelvic inflammatory disease and pelvic effusion from February 2013 to March 2016 in our hospital were selected and divided into the control group and the observation group , 30 cases in each group.The control group were treated with fosfomycin trometamol power, and the observation group were additionally treated with Guizhi Fuling capsules.The therapeutic effects and changes of TCM syndrome scores were compared between the two groups.The levels of serum C reactive protein ( CRP ) in the two groups were determined before and after treatment and the ultrasound examination was performed and changes of pelvic effusion diameter was determined before and after treatment.Results The total effective rate of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).There was no significant difference in TCM syndrome scores between the two groups before treatment .After treatment, the TCM symptom scores of both groups were decreased, the difference was statistically significant ( P<0.05 ) .The scores of lumbosacral swelling pain, abdominal pain, morbid leucorrhoea increase, fatigue, low-grade fever and soreness of waist in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05).Before treatment, there was no statistically significant difference in pelvic effusion and CRP levels between the two groups.After treatment, the pelvic effusion diameter and CRP levels were decreased, the difference was statistically significant (P<0.05), and those in the observation group were lower than the control group, the difference was statistically significant (P<0.05). Conclusion Guizhi Fuling capsules combined with the fosfomycin trometamol power is significantly effective in the treatment of pelvic inflammatory disease and pelvic effusion.It can significantly reduce the inflammatory reactions of patients, and improve the TCM syndrome scores.
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Objective To observe clinical effect of treating pelvic effusion with twenty five tastes podophyllum pill combined with antibiotics, microwave. Methods 182 cases patients with inflammatory pelvic effusion were randomly divided into two groups. The treatment group was treated with twenty five tastes podophyllum pill combined with antibiotics、microwave, and the control group was treated with antibiotics combined with microwave. The absorption, symptoms disappeared and cure situations of pelvic effusion were observed between control group and treatment group after treatment.Results The complete absorption, symptoms disappeared and cure situations of pelvic effusion in the treatment group was significantly higher than that of the control. The total effective rate of the treatment group was 100%, and the total effective rate of the control group was 87.5%, which has a significant difference (P<0.05) .Conclusion The treatment of twenty five tastes podophyllum pill combined with antibiotics, microwave on pelvic effusion is better than western medicine.