Axillary Web Syndrome: characterization of the different forms of clinical presentation of the cord.

ObjectiveDescribe and characterize the forms of presentation and manifestation of the cord present in the Axillary Web Syndrome.Materials and MethodsAfter a favorable opinion from the Research Ethics Committee of the Federal University of Goiás, the construction of items for the Axillary Web Syndrome Classification Scale began, based on the search for concepts involved in its diagnosis. The various steps of construction, application and validation of the instrument occurred from April 2020 to August 2021. The research took place at the outpatient clinic of Mastology at Hospital das Clínicas (Goiás). In the evaluation position: supine, upper limb ipsilateral to the breast operated in abduction, extension and external rotation of the shoulder, extension and supination of the elbow, extension of the wrist and fingers, information on the specific characteristics of the cord was recorded.ResultsThe means presented by the evaluators were almost identical for the variables related to the characterization of the cord, indicating a strong correlation, Cronbach's alpha was 0.894 for evaluator 1 and 0.879 for evaluator 2, indicating strong internal consistency. Inter-rater agreement was 100% (p>0.001) for almost all variables evaluated, with the lowest Kappa coefficient (0.77 p>0.001) for “Length”.ConclusionA consensus on classification criteria can be useful among researchers and practitioners. The fibrous cord classification items compiled in this study address its forms of presentation and manifestation and contribute to standardizing the assessment and classification of Axillary Web Syndrome.

A review of Chinese medicine for the treatment of psoriasis: principles, methods and analysis

Chinese medicine (CM) has a long history in the treatment of psoriasis, and its different understanding angle and treatment mode from modern medicine have unique wisdom. In this article, we consulted a large number of literatures and collected data in order to systematically clarify how CM understands psoriasis, including the classification and judgment of syndrome types, the diagnosis and thinking of etiology and pathogenesis, the application of treatment ideas, principles, methods and various prescriptions, and suggestions on patient care, so as to provide a clear CM treatment process and experience for the world clinic. In addition, we analyzed the efficacy and safety through clinical data, and summarize the methods and prescriptions worthy of promotion, so as to provide reference for doctors to prescribe prescriptions and medication. Finally, we found that compared with modern medicine, CM has unique advantages in the treatment of psoriasis, including the uniqueness of syndrome classification, the abundantly and flexibility of treatment ideas. Not only many famous doctors have studied the ideas in ancient books, but also made great efforts to innovate, which has left a lot of valuable experiences for clinical practice. Moreover, a large number of treatment methods, prescriptions and medicines have achieved high effectiveness and safety in clinical practices for many years, which has been proved to be worthy of clinical reference and in-depth research. In addition, we also think about the deficiencies of CM in the treatment of psoriasis and the direction of breakthrough combined with modern medicine. The treatment of psoriasis with CM is worth popularizing, and we hope it can benefit more patients.

Ictal semiology of epileptic seizures with insulo-opercular genesis

Objective Epileptic seizures with insular genesis are often difficult to distinguish from those originating in the temporal lobe due to their complex and variable semiology. Here, we analyzed differentiating characteristics in the clinical spectrum of insulo-opercular seizures. Methods Ictal semiology in patients with a diagnosis of insulo-opercular epilepsy (IOE) based on imaging of epileptogenic lesions or electrophysiological evidence of an insulo-opercular seizure origin was retrospectively analyzed and compared to age-matched controls with mesial temporal lobe epilepsy (MTE). Results Forty-six IOE and 46 matched MTE patients were included. The most prominent ictal features in IOE were focal motor phenomena in 80.4% of these patients. Somatosensory sensations, version, tonic and clonic features, when present, were more frequent contralateral to the SOZ in MTE patients, while they occurred about equally often ipsilateral and contralateral to the SOZ in IOE patients. Ipsilateral manual automatisms were significantly more frequent in MTE patients than in IOE (p = 0.010). Multivariate analysis correctly identified IOE in 78.3% and MTE in 84.8% using five semiologic features (Chi-square = 53.79 with 5 degrees of freedom, p < 0.0001). A subanalysis comparing patients with purely insular lesions with MTE patients using only the earliest ictal signs showed that somatosensory sensations are significantly more frequent in insular epilepsy (p = 0.010), while automatisms were significantly more frequent in MTE patients (p = 0.06). Significance Our study represents the first in-depth analysis of ictal semiology in IOE compared to MTE. Use of these differentiating characteristics can serve for a correct syndrome classification and to steer appropriate diagnostic and local therapeutic procedures.

A New Method for Syndrome Classification of Non-Small-Cell Lung Cancer Based on Data of Tongue and Pulse with Machine Learning

Objective. To explore the data characteristics of tongue and pulse of non-small-cell lung cancer with Qi deficiency syndrome and Yin deficiency syndrome, establish syndrome classification model based on data of tongue and pulse by using machine learning methods, and evaluate the feasibility of syndrome classification based on data of tongue and pulse. Methods. We collected tongue and pulse of non-small-cell lung cancer patients with Qi deficiency syndrome ( n = 163 ), patients with Yin deficiency syndrome ( n = 174 ), and healthy controls ( n = 185 ) using intelligent tongue diagnosis analysis instrument and pulse diagnosis analysis instrument, respectively. We described the characteristics and examined the correlation of data of tongue and pulse. Four machine learning methods, namely, random forest, logistic regression, support vector machine, and neural network, were used to establish the classification models based on symptom, tongue and pulse, and symptom and tongue and pulse, respectively. Results. Significant difference indices of tongue diagnosis between Qi deficiency syndrome and Yin deficiency syndrome were TB-a, TB-S, TB-Cr, TC-a, TC-S, TC-Cr, perAll, and the tongue coating texture indices including TC-CON, TC-ASM, TC-MEAN, and TC-ENT. Significant difference indices of pulse diagnosis were t4 and t5. The classification performance of each model based on different datasets was as follows: tongue and pulse < symptom < symptom and tongue and pulse. The neural network model had a better classification performance for symptom and tongue and pulse datasets, with an area under the ROC curves and accuracy rate which were 0.9401 and 0.8806. Conclusions. It was feasible to use tongue data and pulse data as one of the objective diagnostic basis in Qi deficiency syndrome and Yin deficiency syndrome of non-small-cell lung cancer.