This 8-week, randomized, placebo-controlled, double-blind clinical study investigated the short-term effectiveness and safety of the traditional Chinese medicine, Ningdong (ND) granule in paediatric subjects (aged 7 - 18 years) with Tourette's disorder (TD). Subjects received either 1 g/kg per day ND granule (n = 33) or placebo (n = 31) and tics were measured at baseline and after 4 and 8 weeks of treatment. Body mass index, electrocardiogram and laboratory measures were recorded at baseline and at week 8. After 8 weeks of treatment with ND granule, subjects exhibited a 41.39% reduction in the total tic score while the placebo group showed a 10.79% decrease. Regarding side-effects, two subjects reported loss of appetite and one experienced constipation in the ND granule group. There were no significant changes in laboratory and physical examinations. These results suggest that ND granule is both effective and safe, and may be a good candidate for the treatment of patients with TD.

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A 6-week duration of anticoagulation appears to be an effective and safe treatment for isolated axial distal DVT, with low rates of VTE recurrence and proximal propagation.

Background The clinical utility of fatty meal stimulated cholescintigraphy particularly using a standardized formulation in patients with suspected functional gallbladder disorder has not been extensively studied. We present our seven‐year clinical experience using an Ensure plus protocol. Methods A retrospective study was performed on patients undergoing stimulated cholescintigraphy using Ensure Plus for evaluation of suspected functional gallbladder disorder. A gallbladder ejection fraction (GBEF) of <33% was considered abnormal. Results Of the 173 patients evaluated, 57 (33%) had an abnormal GBEF, 112 (65%) had a normal GBEF and 4 (2%) had no gallbladder visualization. Of the 57 patients with an abnormal GBEF, symptom improvement occurred in 30/31 (97%) who underwent cholecystectomy and in 17/26 (65%) who were managed conservatively (p = 0.003). Of the 112 patients with a normal GBEF, symptom improvement occurred in 8/10 (80%) who underwent cholecystectomy and 74/102 (73%) who were managed conservatively (p = 1.000). In the subgroup of 102 patients with a normal GBEF managed conservatively, those without symptomatic improvement had lower GBEFs compared to those with symptomatic improvement (median GBEF 46% versus 57%, p = 0.019). Conclusion Our retrospective results support a clinical role for stimulated cholescintigraphy using Ensure Plus in the evaluation of patients with suspected functional gallbladder disorder. While an abnormal GBEF predicts good surgical outcome, our results suggest that using an absolute GBEF cut off value of <33% may not apply to all patients and hence GBEF results should only be used as an adjunct in the surgical decision‐making process.

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