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Objective To observe the effect of Huangqi granules combined with external treatment on the clinical therapeutic effects of typeⅡand Ⅲ stress injuries. Methods A total of 240 patients with typeⅡ andⅢ pressure injuries admitted to the Hengshui People's Hospital from January 2017 to March 2019 were enrolled. According to difference in therapeutic methods, the patients were divided into astragalus mongholicus granule group and routine treatment of Western medicine group, with 120 cases in each group. In both groups, the patients were given routine nursing treatment such as air cushion bed, regular body turn-over, nutrition support, health education, etc;in routine Western medicine treatment group, according to the principle of aseptic dressing change, the wounds were treated and covered with foam dressing; while in the astragalus mongholicus granule group, the routine nursing care and sterile dressing as above mentioned were also applied, additionally 3 bags of oral astragalus mongholicus granules mixed with boiled water each time, twice a day (equivalent to 10 g for each bag of Chinese herbal slices), 7 days as one course of treatment; at the same time, the wound was sterilized, debrided and washed with normal saline, and after drying, the rubber Shengji ointment for promoting growth of tissue was evenly spread on the wound and covered with foam dressing. In the two groups, the changes of pressure ulcer healing evaluation scale (PUSH) scores before treatment and 7, 14, 21 and 28 days after treatment, as well as the differences in wound healing time and clinical efficacy between the two groups after treatment were observed, and the recurrence rate was followed up for 10 weeks. Results Compared with routine Western medicine group, the Ⅱand Ⅲ wound healing times were significantly reduced in the astragalus mongholicus granule group [the days of wound healing for Ⅱ stress injury (days): 7.81±1.40 vs. 16.52±1.89, the days of wound healing for Ⅲ stress injury (days): 14.60±1.50 vs. 20.23±1.27, both P < 0.05]. With the prolongation of therapeutic time, the PUSH scores of two groups decreased gradually, there was no significant difference in the PUSH scores between the two groups before treatment and 7 days after treatment (both P > 0.05); after 14 days of treatment, the PUSH score of astragalus mongholicus granule group was significantly lower than that of the routine western medicine group (7.82±1.93 vs. 9.96±1.89), and lasted until 28 days (4.16±0.47 vs. 5.29±0.57), the differences being statistically significant (both P < 0.05). The total effective rate of the astragalus mongholicus granule group was significantly higher than that of the routine western medicine treatment group [99.41% (171/172) vs. 74.51% (114/153), P < 0.05], and the recurrence rate of the mongholicus granule group was obviously lower than the routine Western medicine treatment [3.60% (5/139) vs. 17.74% (11/62), P < 0.05]. Conclusion Oral astragalus mongholicus granules combined with myocreatic ointment external therapy can effectively shorten the healing time of type Ⅱand Ⅲ stress injury, improve the cure rate and reduce the recurrence rate.
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Objective To explore the effect of sucralfate on cytokines in rats with paraquat (PQ) poisoning. Methods Seventy-two healthy male Sprague-Dawley (SD) rats were randomly divided into PQ model group, sodium bicarbonate intervention group (SB group) and sucralfate suspension gel group (LTL group), with 24 rats in each group. The rat model of PQ poisoning was reproduced by one-time intragastric administration of PQ solution 25 mg/kg. The rats in SB group and LTL group were intragastricly administrated with 5 mL·kg-1·d-1of 100 g/L sodium bicarbonate or 200 g/L sucralfate at 2 hours after exposing to PQ, and the rats in PQ model group were given the same amount of sterile saline. The abdominal aortic blood of rats was collected at 1, 3, 6, and 10 days after PQ poisoning, and the levels of serum tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1) were determined by enzyme-linked immunosorbent assay (ELISA). The left lung tissue was harvested, and lung wet/dry weight (W/D) ratio was assessed. Results With prolonged exposure, lung W/D ratios in all the groups were increased gradually, reached the peak at 10 days, but in the SB group and LTL group, the amplitude of increase was obviously reduced, the ratios were significantly decreased at 6 days and 10 days as compared with those in PQ model group (SB group vs. PQ model group: 4.99±0.79 vs. 6.98±0.86 at 6 days, 5.61±0.36 vs. 7.36±0.95 at 10 days; LTL group vs. PQ model group: 4.61±0.24 vs. 6.98±0.86 at 6 days, 4.24±0.20 vs. 7.36±0.95 at 10 days, all P < 0.05), but there was no significant difference between SB group and LTL group (all P > 0.05). After PQ poisoning, the levels of TNF-α, IL-10 and TGF-β1 were elevated, and reached the peak at 3 days and then decreased gradually. Compared with the PQ model group, serum TNF-α, IL-10 and TGF-β1 levels in SB group and LTL group were decreased significantly [SB group vs. PQ model group: 3-day TNF-α (ng/L) was 147.6±12.3 vs. 168.2±11.3, 3-day IL-10 (ng/L) was 65.4±3.2 vs. 115.1±9.2, 3-day TGF-β1 (ng/L) was 356.3±50.3 vs. 415.6±68.3; LTL group vs. PQ model group: 3-day TNF-α (ng/L) was 82.2±7.4 vs. 168.2±11.3, 3-day IL-10 (ng/L) was 44.4±5.2 vs.115.1±9.2, 3-day TGF-β1 (ng/L) was 296.3±40.2 vs. 415.6±68.3, all P < 0.05], especially in LTL group (all P < 0.05). Conclusion Early gastrointestinal lavage with sucralfate could effectively reduce the inflammatory exudation in lung tissue after PQ poisoning, and inhibit the cytokine secretion.
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Objective To investigate the protective effect of modified Qianjin Weijing Decoction(MQJWJD)on TNF-α and NF-κB in rats with lung injury induced by particulate matter; To discuss relevant mechanism of action. Methods A tracheal drip 15 mg/kg fine particles of saline solution was used to establish modeling, every other day, three times. Thirty-two Wistar rats were randomly divided into normal group, model group and MQJWJD high-dose and low-dose groups, with eight rats in each group. Medication groups were given relevant medicine for gavage. The level of TNF-α in bronchoalveolar lavage fluid (BALF) was measured by ELISA. The expression of NF-κB protein in lung tissues was measured by immunohistochemistry. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the level of TNF-α and the expression of NF-κB protein in the model group were higher than those in the normal group (P<0.01). Compared with model group, the level of TNF-α and the expression of NF-κB protein in MQJWJD low-dose and high-dose groups were lower than those in the model group (P<0.05, P<0.01). Pathological observation showed that, compared with normal group, model group showed intratracheal, alveolar and interstitial bacteria within a large number of fine particles calm, alveolar and pulmonary interstitial visible large amounts of phagocytic fine particles of macrophages and accompanied by more neutrophils and lymphocyte infiltration; Lung tissue pathological changes were significantly lighter in MQJWJD high-dose and low-dose groups than the model group. MQJWJD high-dose group showed mild inflammation, alveolar and pulmonary interstitial visible phagocytic fine particles of macrophages, a small amount of neutrophils and lymphocyte infiltration. Conclusion MQJWJD can reduce the pulmonary injury in rats induced by particulate matter and has protective effects on the rat model through decreasing the levels of TNF-α and the expressions of NF-κB protein in injured lung tissues.
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Objective To improve the diagnosis and treatment of type Ⅰ autoimmune pancreatitis, a study was carried out to summarize the epidemiological characteristics, clinical manifestations and diagnosis of autoimmune pancreatitis (AIP).Methods This study retrospectively analyzed the clinical data of all the patients diagnosed with AIP from January 1998 to December 2016 in the ward of Peking union medical college hospital.Results 194 type 1 AIP patients were enrolled in this study.The M/F ratio of the disease was 3.51/1,with an average age of 57±15 years.The most common symptom is jaundice, abdominal pain and weight loss.The most common diseases of the pancreas are sclerosing cholangitis, salivary glands, IgG4 nephropathy.There are 36.68 percent of AIP patients with diabetes mellitus.IgG4, ANA, ESR, c-reactive protein and CA199 are all contribute to disease diagnosis and follow-up.Pathology, pet-CT and hormone therapy response all contribute to the diagnosis of AIP.Conclusions As a systemic disease, the type 1 AIP has special clinical features and laboratory profiles.The diagnosis of AIP can be applied in many ways.
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Objective To investigate the early diagnosis and surgery timing of strangulated intestinal obstruction.Methods The clinical data of 90 patients with strangulated intestinal obstruction who were admitted into our hospital from January 2013 and January 2016 were retrospectively analyzed.And these patients were divided into the early stage group (28 cases) and the later stage group (62 cases).The rate of mortality and the rate of necrotic bowel resection of the two groups were analyzed.Results Among the 90 patients underwent emergency surgery,there were 88 cases cured and 2 cases died,and there were 10 cases (11.11％) of necrotic bowel resection among the survivor.In the early stage group,there were 8 cases of necrotic bowel resection and 1 case of death.In the later stage group,there were 2 cases of necrotic bowel resection and 1 case of death.Conclusion Early diagnosis and prompt surgical treatment can reduce the mortality of strangulation obstruction and necrosis of bowel resection.
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Objective To sum up the experience in diagnosis of fungal esophagitis. Methods An analysis was per-formed on clinical data of 38 cases of fungal esophagitis diagnosed through gastroscopy in Peking Union Medical College Hospital from Jan. 2013 to Dec. 2015. Results Of 38 cases, 26 were males and 12 were females. The mean age was(54.0±1.5) years old.76.3% had at least one risk factor.7 patients had oral candidiasis and 10 pa-tients had typical symptom of fungal esophagitis. Endoscopic severity was classified according to Kodsi's grade:gradeⅠ6 cases,grade Ⅱ29 cases, grade Ⅲ 1 case,grade Ⅳ 2 cases. Most patients were treated with systemic antifungal therapy. However,one patient's fungal esophagitis resolved without any treatment. Conclusions Endos-copy with biopsy is a valuable definitive diagnostic method for fungal esophagitis, especially for asymptomatic pa-tients or those without oral candidiasis. Systemic antifungal treatment is recommended with fluconazole as the first choice. More evaluation is needed to determine if systemic antifungal therapy is necessary for asymptomatic and im-munocompetent patients with mild fungal esophagitis.
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Objective To sum up the experience in diagnosis of fungal esophagitis. Methods An analysis was per-formed on clinical data of 38 cases of fungal esophagitis diagnosed through gastroscopy in Peking Union Medical College Hospital from Jan. 2013 to Dec. 2015. Results Of 38 cases, 26 were males and 12 were females. The mean age was(54.0±1.5) years old.76.3% had at least one risk factor.7 patients had oral candidiasis and 10 pa-tients had typical symptom of fungal esophagitis. Endoscopic severity was classified according to Kodsi's grade:gradeⅠ6 cases,grade Ⅱ29 cases, grade Ⅲ 1 case,grade Ⅳ 2 cases. Most patients were treated with systemic antifungal therapy. However,one patient's fungal esophagitis resolved without any treatment. Conclusions Endos-copy with biopsy is a valuable definitive diagnostic method for fungal esophagitis, especially for asymptomatic pa-tients or those without oral candidiasis. Systemic antifungal treatment is recommended with fluconazole as the first choice. More evaluation is needed to determine if systemic antifungal therapy is necessary for asymptomatic and im-munocompetent patients with mild fungal esophagitis.
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Objective To observe the curative effect of continuous gastrointestinal decompression after gastric lavage with edible oil on saving patients with oral aluminum phosphide poisoning.Methods Seventy-eight patients with oral aluminum phosphide admitted to the Department of Internal Emergency of the Second People's Hospital of Yunnan Province from October 2009 to October 2016 were divided into a mild poisoning group (39 cases), a moderate poisoning group (26 cases) and a severe poisoning group (13 cases) according to clinical manifestations and laboratory examinations, all the patients were treated with continuous gastrointestinal decompression after early gastric lavage with edible oil, including scavenging toxicant, correcting intracellular oxygen intake and metabolic disturbance, and inhibiting and eliminating inflammatory mediators. The difference of remission times of clinical symptoms, recovery times of abnormal indexes and hospitalization times were compared among patients with different disease severities. Results With the aggravation of disease, the remission times of clinical symptoms (hours: from mild to severe were 24±12, 54±18, 84±12), recovery times of abnormal indexes (hours: from mild to severe were 18±6, 72±0, 108±12) and hospitalization times (hours: from mild to severe 48±24, 120±24, 144±24) were all gradually extended. Of the 13 patients with severe poisoning, 2 patients died of multiple organ functional failure (MOF) after 28 hours of treatment because they were incapable of cooperating with continuous gastrointestinal decompression. There were 76 patients were clinically cured, the cure rate being 97.4%. In the follow-ups at 1 month and 6 months after the treatment, no abnormalities were seen.Conclusion Continuous gastrointestinal decompression after early gastric lavage with edible oil for saving patients with oral aluminum phosphide poisoning is an effective therapy worthwhile to be popularized.
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Objective To observe the changes of ENA -78 expression levels in patients with endometriosis (EM)before and after treatment,and the role of ENA -78 expression in pain and pelvic inflammation.Methods A total of 160 patients with EMwere selected as the research subjects for I phase,II phase,III phase,IV phase patients.In the same period,40 cases of non EMpatients were selected as control group.Serum ENA -78 expression levels were detected among patients with EM before treatment,3 months after treatment and 6 months after treatment,and the control group before treatment by the method of ELISA .The correlation between ENA -78 expression and pelvic inflammatory adhesion and pain grading among patients with EMwas analyzed.Results There was significant difference in the level of serum ENA -78 expression between the two groups at different time points (P <0.01).The expression level of serum ENA -78 of case group decreased with time (P <0.01),while the expression level of serum ENA -78 of EM patients with different pain grading was different (P <0.05).The expression level of ENA -78 in severe group was higher than that in mild group and moderate group (P <0.05).The degree of pelvic adhesion in EMpatients was positively correlated with the level of ENA -78 expression (rs =0.675,P =0.000).The expression of ENA -78 in serum of EMpatients with different degrees of pelvic inflammation was different (P <0.05 ),and the expression of V -grade group ENA -78 was higher than other <br> groups (P <0.05).The level of ENA -78 expression was positively correlated with the degree of pain in patients with EM (rs =0.601,P =0.000).Conclusion Serum ENA -78 expression levels among EM patients were high,and positively correlated with pelvic inflammatory adhesion and pain grading.Serum ENA -78 decreased after GnRh -a treatment.
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Serum sialic acid (SA) levels were detected by neuraminidase method in 366 patients with malignant tumor, 40 patients with benign diseases and 40 healthy subjects.For 277 malignant tumor patients, serum SA levels were monitored before and after treatment.The serum SA levels in malignant tumor group were significantly higher than those in benign diseases and control groups (P ＜0.01 ), but there were no differences between normal and benign groups (P ＞0.05 ).Serum SA levels were decreased in malignant tumor patients with remission and stable disease after treatment.In remission or stable patients the decrease of serum SA levels occurred in the first three months and no changes were found from the fourth to sixth month; meanwhile SA levels were elevated in patients with instablc condition.
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<p><b>OBJECTIVE</b>To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP).</p><p><b>METHODS</b>Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups: acute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzyme-linked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CK(max) (maximum of creatinkinase), CK-MB(max) (maximum of isozyme of creatinkinase) and cTnI(max) (maximum of troponin) were measured by standard laboratory methods.</p><p><b>RESULTS</b>The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and 1.12 folds in SAP patients than in the healthy controls (P<0.05). The resistin levels were also significantly different between AMI [(8.16+/-0.79) ng/ml], UAP [(5.59+/-0.75) ng/ml] and SAP [(3.45+/-0.56) ng/ml] groups (P<0.01); WBC, hsCRP, CK(max), CK-MB(max) and cTnI(max) were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r=0.412, P=0.046), hsCRP (r=0.427, P=0.037), CK(max), CK-MB(max) and cTnI(max) (r=0.731, 0.678, 0.656; P<0.01).</p><p><b>CONCLUSION</b>Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.</p>
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Female , Humans , Male , Middle Aged , Acute Coronary Syndrome , Blood , Angina Pectoris , Blood , Myocardial Infarction , Blood , Resistin , BloodABSTRACT
OBJECTIVE To study the quantitative bacteriology of sputum in patients with lower respiratory tract infection. METHODS A total of 1534 samples were collected from 1351 patients.Bacterial culture,drugs sensitive test and quantitative analysis were carried out.The pathogens were confirmed by VITEK-32 and API system.MIC test was adopted to analyze drug resistance. RESULTS The 1605 strains were isolated of the 1534 samples.The common pathogens were Escherichia coli 24.3%,Klebsiella pneumoniae 20.7%,Streptococcus pneumoniae 20.7%,Enterobacter cloacae 10.9%,Staphylococcus aureus 10.4%,Haemophilus influenzae 8.7%,Pseudomonas aeruginosa 5.9%,and Moraxella catarrhalis 4.0%. CONCLUSIONS Sputum cultures usually can not accurately reflect the etiology.Diagnosis of lower respiratory tract infection is based on clinical symptoms.A sputum Gram staining may show many mononuclear or polymorphonuclear cells in viral or bacterial infections,respectively.
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Spontaneous renal subcapsular hematoma is a rare, life-threatening condition that is usually caused by benign and malignant renal tumors, vascular diseases, inflammatory disorders, blood dyscrasias, and seldom suspected clinically. The characteristic clinical features are abdominal pain, a mass in the flank and signs of internal bleeding. Severe preeclampsia is also a major contributing factor of the renal hematoma. Because renal function is decreased in spontaneous renal subcapsular hematoma, physicians should be aware of the clinical symptoms and signs, appropriate investigation and management may be life-saving. This case of spontaneous renal subcapsular hematoma and acute renal failure complicated by severe preeclampsia, which occurred after delivery and was treated conservatively.
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Female , Pregnancy , Abdominal Pain , Acute Kidney Injury , Cesarean Section , Hematoma , Hemorrhage , Pre-Eclampsia , Vascular DiseasesABSTRACT
OBJECTIVE: The qualitative test of fibronectin of the cervices and vaginae as well as the C-reactive protein test of pregnant mothers with symptoms of preterm labor were performed in an attempt to examine clinical validity of these factors as predictable elements of preterm delivery. METHODS: This prospective study was conducted on ninety (90) single pregnancies of gestational age from 24 weeks and 1 day to 34 weeks and 6 days admitted to the hospital with symptoms of preterm labor, which occurred in the period from October 1, 1999 through March 31, 2001. Among these pregnant women, those with a uterine contraction rate of 4 per hour or greater and uterine dilatation of less than 3 cm without PROM were used as the subjects. The qualitative test of fetal fibronectin (ROM check, Adeza Biochemical, USA) of the cervices and vaginae as well as the C-reactive protein test by means of latex agglutination method using maternal blood were performed on these subjects. Of the 90 mothers that participated in this study, 15 dropped out and 75 underwent the qualitative test of fetal fibronectin and C-reactive protein test. The results of each test and the combined tests of both at preterm delivery (1) within 1 week, (2) prior to 34 weeks and (3) prior to 37 weeks were compared and analyzed. RESULTS: 1. 22.4% (15/67) resulted in preterm delivery prior to 34 weeks while 48.0% (36/75) ended up with preterm delivery prior to 37 weeks. 2. In predicting preterm delivery within 7 days and prior to 37 weeks after the test, the fetal fibronectin and C-reactive protein qualitative test were statistically insignificant. The combined tests of both fetal fibronectin and C-reactive protein were statistically insignificant in predicting preterm delivery within 7 days (Odds ratio of 4.2; 95% CI 0.7-23.3 p=0.199) and prior to 37 weeks (Odds ratio of 5.3; 95% CI 0.6-48.3 p=0.116). 3. In predicting preterm delivery prior to 34 weeks, fetal fibronectin and C-reactive protein qualitative test were insignificant statistically. Nevertheless, these two tests in combination showed a statistical significance for preterm delivery prior to 34 weeks: It showed a sensitivity of 26.7% (4/15), a specificity of 95.6% (43/45), a positive predictability of 66.7% (4/6), and negative predictability of 79.6% (43/53) [Odds ratio of 7.8; 95% CI 1.3-48.3, p=0.03]. CONCLUSION: Specificity and positive predictive value improved when the combined fetal fibronectin and C-reactive protein tests in pregnancies with symptoms of preterm labor were performed for preterm delivery before 34 weeks. Consequently, this is a clinically valid predictor of preterm delivery before the 34th week.
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Female , Humans , Pregnancy , Agglutination , C-Reactive Protein , Dilatation , Fibronectins , Gestational Age , Latex , Mothers , Obstetric Labor, Premature , Pregnant Women , Premature Birth , Prospective Studies , Sensitivity and Specificity , Uterine Contraction , VaginaABSTRACT
OBJECTIVE: To determine the effect of myomectomy as a treatment for infertility and to define the factors that influence reproductive outcomes MATERIALS AND METHODS: During the period from January 1995 to December 2001, on 39 patients who suffered from infertility and habitual abortion underwent transabdominal myomectomy at the Department of Obstetrics and Gynecology in Chonbuk National University Hospital. RESULTS: Pregnancy occurred in 31 women. The mean age was 32.3 years. The pregnancy rates in women with or without associated factors in addition to myoma were 55.5% and 71.4%, respectively, and those in women with 2 years of infertility were 73.7% and 55%, respectively. In case of women with myoma on lateral side, pregnancy rate was 33.3%. Considering the size, women with a myoma, 30~50 mm in size had higher pregnancy rate (81.2%). The 24-month cumulative probability of conception was 91% in patients 35 years of age. CONCLUSION: Our results suggest a benefit of myomectomy in infertile patients. Factors affecting the pregnancy rate after myomectomy in theses patients are the age of the patient, the duration of infertility, the site of myoma, and the size of myoma <50 mm. However, women should be counseled carefully before surgery because the determinants of outcome appear to be independent of treatment.
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Female , Humans , Pregnancy , Abortion, Habitual , Fertilization , Gynecology , Infertility , Myoma , Obstetrics , Pregnancy RateABSTRACT
Objective :To establish a RP-HPLC method for the determination geniposide in Yigan Liangcha.Methods Luna C18 (4.6 mm?250 mm,5 ?m)was applied,the mobile phases consisted of acetonitrile-water(15∶85),the flow rate was 1.0 mL?min-1 and the detection wavelength at 238 nm.Results The average recovery of geniposide was 98.1 %and RSD were 0.42 %(n=5).There is a good linear relationship within the range of 10.12～50.60 ?g of geniposide.Conclusion The method is convenient,sensitive,accurate and reproducible and can be used the quality control of the Yigan Liangcha.