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Traditional Chinese Medicine (TCM) has its own unique features in the treatment of post-stroke depression (PSD). The kidney is the congenital foundation and is closely related to the brain. Kidney deficiency runs through the entire course of stroke. Liver regulates the normal operation of qi in the human body, which is closely related to depression syndrome. Kidney deficiency and liver depression affect each other. The treatment of PSD with the Bushen Shugan (tonifying the kidney and soothing the liver) method has achieved good efficacy in clinic. The method of tonifying kidney and soothing liver can not only reflect the holistic view of TCM and the association of viscera, but also coordinate the relationship between body and spirit. In the future, the development direction of PSD in TCM research should be to further strengthen the concept of co-regulation of body and spirit and integration of brain and viscera.
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Meige syndrome is one of the rare Diseases of neurology. It is a part of the group of segmental cranial dystonia, which affects more than two cranial muscle groups. Especially, blepharospasm is associated with another cranial dystonia. Currently, the etiology and pathogenesis of this disorder are not well-understood. Based on the theory of collaterals and the relationship between collateral disease and five zang organs,we try to classify the disease into the category of collateral disease, and hold that the mechasnism of disease is not only linked to brain, but also the five zang organs. The disorder of qi and blood leads to the "deficiency of qi and blood", "phlegm-damp" and "stagnant blood" in collateral. These pathological changes cause the deficiency of both qi and blood in brain marrow and tendon.We think that "unblocking and regulating the collterals"is the general program. Adjusting the five zang organs to heel the brain is the key point of the treatment. What's more, we create Tongmai Heluo Decoction to regulate qi and blood of the collateral. This decoction is composed of Huangqi Jianzhong Decoction with some herbal medicine for tonifying qi and activating blood. By adjusting the middle energizer, the qi and the qi movement of five zang organs are well regulated. We use this decoction effectively on refractory Meige syndrome.
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OBJECTIVE@#To evaluate the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery for treatment of type 2 diabetes (TD) in patients with a body mass index (BMI) < 27.5 kg/m.@*METHODS@#We retrospectively analyzed the data of patients who underwent LRYGB surgery from March, 2012 to June, 2018 in the General Hospital of Guangzhou Military Command and Jinshazhou Hospital of Guangzhou University of Chinese Medicine. The changes in the parameters of glucose metabolism and physical indicators of the patients in the first, second and third years after the surgery were analyzed in patients in low BMI group and high BMI group.@*RESULTS@#All the 74 patients underwent LRYGB successfully without conversion to open surgery. One year after the surgery, fasting blood glucose (FBG), HbA1c, postprandial blood glucose, fasting insulin, HOMA-IR, fasting C-peptide, BMI, body weight and waistline were significantly improved compared with their preoperative values in low BMI group ( < 0.05). At 2 years after the operation, FBG, HbA1c, postprandial blood glucose, HOMA-IR, BMI, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). In the third year, FBG, HOMA-IR, fasting C-peptide, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). There was no significant difference in the parameters of glucose metabolism and islet function between low BMI group and high BMI group at different stages. No serious complications occurred in these patients after the surgery.@*CONCLUSIONS@#LRYGB is effective for treatment of T2D in Chinese patients with a BMI < 27.5. After the surgery, the patient show reduced waistline without significant weight loss. The long-term results of the surgery still require further investigations with a larger samples and longer follow-up.
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Humans , Body Mass Index , Diabetes Mellitus, Type 2 , Gastric Bypass , Laparoscopy , Obesity, Morbid , Retrospective Studies , Treatment Outcome , Weight LossABSTRACT
OBJECTIVE@#To evaluate the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery for treatment of type 2 diabetes (TD) in patients with a body mass index (BMI) < 27.5 kg/m.@*METHODS@#We retrospectively analyzed the data of patients who underwent LRYGB surgery from March, 2012 to June, 2018 in the General Hospital of Guangzhou Military Command and Jinshazhou Hospital of Guangzhou University of Chinese Medicine. The changes in the parameters of glucose metabolism and physical indicators of the patients in the first, second and third years after the surgery were analyzed in patients in low BMI group and high BMI group.@*RESULTS@#All the 74 patients underwent LRYGB successfully without conversion to open surgery. One year after the surgery, fasting blood glucose (FBG), HbA1c, postprandial blood glucose, fasting insulin, HOMA-IR, fasting C-peptide, BMI, body weight and waistline were significantly improved compared with their preoperative values in low BMI group ( < 0.05). At 2 years after the operation, FBG, HbA1c, postprandial blood glucose, HOMA-IR, BMI, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). In the third year, FBG, HOMA-IR, fasting C-peptide, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). There was no significant difference in the parameters of glucose metabolism and islet function between low BMI group and high BMI group at different stages. No serious complications occurred in these patients after the surgery.@*CONCLUSIONS@#LRYGB is effective for treatment of T2D in Chinese patients with a BMI < 27.5. After the surgery, the patient show reduced waistline without significant weight loss. The long-term results of the surgery still require further investigations with a larger samples and longer follow-up.
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Humans , Body Mass Index , Diabetes Mellitus, Type 2 , General Surgery , Gastric Bypass , Laparoscopy , Retrospective Studies , Treatment Outcome , Weight LossABSTRACT
Absctact: Objective To discuss the correlation between the TCM syndromes and the clinical pathological features of central air way non-small cell lung cancer.MethodsTCM syndromes were determined through inquiry and physical examination for 109 cases of lung cancer patients. Remaining specimens after excision and routine pathological examination were under HE staining for pathological diagnosis and study. The correlation between the TCM syndromes and the clinical pathological features was analyzed.ResultsThe histological types of central airway non-small cell lung cancer comprised squamous cell carcinoma (69/109, 63.3%), salivary type carcinoma (27/109, 24.8%), adenocarcinoma (10/109, 9.2%) and other rare carcinomas (adenosquamous, 2/109, 1.8%; sarcomatoid carcinoma, 1/109, 0.9%). The clinical and pathological features showed that the elderly, male, smoking patients most commonly suffered from squamous cell carcinoma, while the young, female, non-smoking patients suffered from salivary type carcinoma most frequently. The distribution characteristics showed that the qi-yin deficiency syndrome was most common in squamous cell carcinoma and salivary type carcinoma, accounting for 41.4% (29/70) and 40.7% (11/27) respectively; qi-deficiency and phlegm-dampness syndrome was most common in adenocarcinoma, accounting for 50.0% (6/12). TCM syndrome types were closely related to sex, to smoking history, and to Karnofsky score respectively, with statistical significance (P<0.05,P<0.01). The qi-yin deficiency syndrome was common in male, smoking patients, while the qi-deficiency and phlegm-dampness syndrome and yin-deficiency and heat-toxin syndrome were common in female and non-smokers. The qin-yin deficiency syndrome was common in patients of Karnofsky score≥60, and qi-deficiency and phlegm-dampness syndrome was most frequently found in <60 scores group.Conclusion The histological types of central air way non-small cell lung cancer are related to age, gender and smoking history of patients. Patients with different ages, genders and smoking histories distribute differently in TCM syndrome.
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<p><b>OBJECTIVE</b>To compare the efficacy difference between's flying acupuncture combined with conventional treatment and conventional treatment alone on acute cerebral infarction hemiplegia.</p><p><b>METHODS</b>A total of 120 patients were randomly divided into an observation group and a control group, 60 cases in each one. The control group was treated with conventional treatment, including anti-platelet aggregation, lipid-lowering, formula of traditional Chinese medicine which could promote circulation and remove stasis, neurotrophic medication and symptomatic treatment; mannitol was used for cerebral infarction with large area or increased intracranial pressure. Based on the conventional treatment applied in the control group, the observation group was treated with flying acupuncture at the affected Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Waiguan (TE 5), Hegu (LI 4), Huantiao (GB 30), Biguan (ST 31), Futu (ST 32), Zusanli (ST 36), etc. The treatment was given once a day, six days per week, for totally 2 weeks. The simplified Fugl-Meyer score, National Institute of Health Stroke Scale (NIHSS) and ADL-Bathel index (BI) score were evaluated before and after treatment in the two groups.</p><p><b>RESULTS</b>After the treatment, the simplified Fugl-Meyer and BI were significantly increased in both groups (all<0.05), which was significantly higher in the observation group (both<0.05); after the treatment, the NIHSS was significantly lowered in both groups (both<0.05), which was significantly lower in the observation group (<0.05).</p><p><b>CONCLUSION</b> 's flying acupuncture combined with conventional treatment were effective for acute cerebral infarction hemiplegia, which have better efficacy than conventional treatment on improving motor function, neurological deficit and daily living ability, and the pain is mild.</p>
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Objective To study the change and the correlation of serum soluble vascular cell adhesion molecuh-1(sVCAM-1)level with diabetic retinopathy in type 2 diabetic patients.Methods 60 type 2 diabetic patients were selected for the study through the examination of ophthalmoscope and/or fundus fluorescence angiography by ophthalmologist.Diabetic patients were divided into three main groups:No signs of diabetic retinopathy(NDR)(n=20);Background DR(BDR)(n=20)Proliferative DR(PDR)(n=20).Healthy individuals matching sex and age of the patients were used as controls(n=20);Serum sVCAM-1 level was measured by ELISA,compared in diabetes without DR,with BDR,with PDR.These levels were compared with those of 20 controls.Results The serum level of sVCAM-1 in the DM patients with PDR or BDR and those without DR were significantly higher than those in healthy controls(all P＜0.001);Serum level of sVCAM-1 in PDR groups were higherthan those in DM patients with BDR or patients without DR(all P＜0.001);There was no difference between the patients with BDR and those without DR (P＞0.05).(4)In the DM patients,there was a positive correlation between serum sVCAM-1 and the course of diseases(r=0.338,P＜0.05),but no relationship with HbA1C,FBG,CHO,TG,LDL and INS.Conclusion Increased serum level of sVCAM-1 in different stage of DR patients suggested that they hagbe play an important role in the development of DR,and may assess the severity of diabetic retinopathy.The measuremem of serum sVCAM-1 levels in type 2 diabetic patients could be clinically useful for early diagnosis or treatment of diabetic retinopathy.
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BACKGROUND: Schwann cells play an important role in axonal growth and myelin sheath formation of the peripheral nerve. Whether Schwann cells play the same role in the spinal cord had attracted considerable attention. Microencapsulation technology as an effective immune isolation technique can effectively keep Schwann cell activity to play the repair effect of Schwann cell in the spinal cord.OBJECTIVE: To observe the changes of myelin sheath in the injured transection of rats after transplantation of the alginic acid microencapsulated Schwann cells.DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Basic Medical School of Nanchang University from March 2005 to February 2008.MATERIALS: Sciatic nerve trunk was obtained from adult rabbits to harvest Schwann cells in vitro using repeatedly differential velocity adherent technique, and to prepare Schwann cell suspension and microencapsulated Schwann cell suspension.METHODS: A total of 146 adult Sprague Dawley rats were used to establish models of right hemi-transection damage at T_(10) level and randomly assigned to four groups: simple injury group (n=44), cell transplantation group (n=44), microencapsulated cell transplantation group (n=44) and normal control group (n=14). At 1, 3, 7,14 and 28 days following surgery, 8 rats were selected from each group at each time point (2 from the normal control group) for perfusion and fixation. Spinal cord tissue was collected to make paraffin section, and then subjected to hematoxylin-eosin staining and Loyez myelin staining. In addition, 2 rats were selected from each group at 2 and 8 weeks. The spinal cord tissue was fixed, embedded in Epon816, stained using uranyl acetate and aluminum citrate, and then observed using an electron microscope.MAIN OUTCOME MEASURES: Neuron number and survival were observed surrounding the damaged region. Structural changes in the myelin sheath from spinal cord white substance at the damage site were measured.RESULTS: At 1 and 3 days following spinal cord injury, spinal neurons were degenerated and necrotic at damaged site, with reduced number of myelin sheath, loose structure, but above-mentioned was rare in the cell transplantation and microencapsulated cell transplantation groups. At 7 days, the reduced number of myelin sheath, with damaged structure was seen. The microencapsulated cell transplantation group was light. At 14 days, number of neurons was increased, with increased cell body, especially in the microencapsulated cell transplantation group. At 28 days, neurons gradually recovered, myelin sheath was gradually complete, with increased number in the microencapsulated cell transplantation group. There were significant differences compared with the simple injury and cell transplantation groups (P < 0.01). At 8 weeks, abundant myelin sheath was repaired, with new myelin sheath in the microencapsulated cell transplantation group.CONCLUSION: Microcapsule has immune isolation effects. Microencapsulated rabbit Schwann cells can promote the repair of rat spinal cord neurons and axonal myelinization.
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By analyzing the achievements made in the management of scientific research and sci-tech innovation in Nanjing General Hospital during the "10th Five-Year Plan" period and their promotive effect on the overall construction of the hospital,this article holds that efficient sci-tech innovation depends on and gains motivation from efficient management innovation.It proposes that the realization of sci-tech innovation is predetermined by a first-rate talent contingent,based on a well-designed innovation platform,supported by blazing new trails in diagnosis and treatment,ensured by optimizing management strategies,and requires the correct handling of the following four relationships: initiative innovation vs talent cultivation,sustainable development vs key emphasis,initiative innovation vs serving the battlefield and market,and initiative innovation vs input and output.
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The article presents the experience, reformation and research of clinical teaching program in the indirectly affiliated school of clinical medicine. The exploration for the establishment of a new teaching mechanism in the school of clinical medicine is implemented.
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Objective: This study aimed to analyze the high medical expenses of hospitalized medical insurance patients for the first ten systemic diseases.Methods: We investigated the medical expenses for the first ten systemic diseases among 10 900 hospitalized medical insurance patients of a hospital,calculated the average expenses and total payment for the treatment of each of the systemic diseases that involved 5% of the total patients,computed their percentage in the total expenses,and compared them with those of all the other hospitalized cases.Results: The medical cost of the 5% of the first 10 hospitalized systemic diseases accounted for 21%-29.9% of the total expenses of all the hospitalized patients,4.3-6.0 times that of the average expenses,and 30.8%-54.9% paid by the patients themselves.In addition,the hospital stay of these patients was 1.5-4.7 times that of the average.Conclusion: The high medical expenses involving 5% of the hospitalized patients with the first 10 systemic diseases amounted to a quarter of those paid by all the hospitalized patients.Effective measures have to be taken to keep high hospitalization expenses at a reasonable level.
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Laboratory animals provide an important basis and supporting conditions for the studies and development of life science,and contribute enormously to people's health,science progress and social development.The welfare of laboratory animals influences their physical and mental health,and consequently the accuracy of research results.Thus,to take good care of laboratory animals and their welfare is an essential prerequisite to the breeding of standard laboratory animals and the accuracy and reliability of research results,and it also marks people's moral accomplishment,the harmony between human and nature,and the progress of social civilization.
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After serious-minded analyzing on the former service process,the manager of our hospital found the problems in the old construction and considered more reasonable design in the new service building.The patient-centered new outpatient building was aimed to meet patient's needs,improve service quality,allocate medical resource,innovate new pattern and optimize the work process.It will provide a bright future for the development of hospital.
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Objective: To investigate the temperature control methods for long-distance transportation of red blood cell suspensions in military affairs or emergence.Methods: We loaded blood transport cars with red blood cell suspensions to full capacity and kept the temperature by combined cooling methods.Results: The temperature in the container was kept between 2-6.2℃ during the 72 h transportation,even when the refrigeration system of the car was out of work.Conclusion: The required temperature for long-distance transportation of red blood cell suspensions could be attained by combined cooling methods in case of insecurity of transportation time and the effect of single cooling method.
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The blood reserve bank for preparedness against war,as a store of blood products and a base of blood supply,bears the responsibility of wartime emergency blood supply.Site selection is the basis of the construction of the blood reserve bank and directly related with its capacity of blood supply in both peace and wartime.The decision-making process concerning site selection is complicated and multi-aimed with various factors mutually related and conditioned.This paper proposes some basic principles of selecting the site of the blood reserve bank for preparedness against war,which are hoped to be beneficial for the demonstration of its site selection.
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Objectives: To investigate the affecting factors on expenditure in Medical insurant inpatients. Methods: 593 medical insurant inpatients, who were from Feb 1, 2001 to Feb 31, 2002 in Nanjing Jinling hospital, were enrolled in this study. The inpatient expenditure was analyzed from the aspect of operation or not, age, and payment mode, used the descriptive analysis and multi factor analysis on affecting factors of the total expense, self bearing expense, and self affording expense. Results: The hospitalized days, operation or not, severity of disease were important affecting factors. The self bearing expense of medical insurant inpatients was associated with hospitalized days, operation or not, and total expense. While the self affording expense of them was associated with expense of drug, hospital bunk, radiation and others. Conclusions: We can control these associated affected factors to lighten the economic weight of patients, and to reduce the ratio of individual payment.
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Laboratory animal science has provided a firm basis and an important support to medical development in our hospital.Through innovations in establishment,ideology,technology,personnel management,scientific research,service,culture,and popular science education,a standard supporting platform of animal experiments has been constructed for medical researches and new trails blazed for the development of medical laboratory animal science.
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This article brieves the significance of the quality of medical records in the mode of basic medical insurance and argues that five aspects concerning quality control should be brought into focus on coordination with the auditing requirements on the medical records put forward by the medical insurance department.The faculty should be educated to become quality-conscious and legality-conscious and the awareness of medical records quality-profit should be imbedded into their minds.The quality control standards of medical records should be set up and the system of quality control,feedback,rewards and punishment should be improved.The monitoring and evaluation by the medical insurance department should be treasured and mutual communication should be enforced to further improve the quality of medical records.
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Thirty eight adult male rabbits were selected for the experiment. The experimental peptic ulcer was induced by means of injection of 40% acetic acid to the submucosa of the stomach. Animals of the control group were injected with normal saline instead and another control group consisted of normal rabbits without any treatment. The animals were killed by decapitation at different time intervals (3～49 days) after the operation. The adrenal tissues were prepared for histochemical studies from both experimental and control animals. The results were observed as follows:During the early stage of the peptic ulcer, the fascicular and reticular zones were the chief sites in the adrenal cortex where histochemical changes were involved. Three days after the peptic ulcer operation, the cells of the fascicular and reticular zones filled with sudanophilic lipid droplets and cholesterol droplets. Five days after the operation, both of lipid droplets and cholesterol droplets decreased; the content of ascorbic acid increased slightly; and the activity of succinic dehydrogenase also increased. The above changes were most conspicuous in the inner portion of the fascicular zone within ten days. After fourteen days, all the above histochemical changes began to recover and gradually returned to the normal level after eighteen to thirty five days. In the normal saline operation control group, the contents of lipid droplets and cholesterol droplets decreased in the fascicular and reticular zones after three days and returned to normal level during the period of ten to fourteen days after operation for saline injection.The above histochemical changes showed that the adrenal cortex was at an active functional state during the early period of the experimental peptic ulcer.
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The purpose of this research work is to find out the longitudinal distribution of the preganglionic neurons which project to the superior cervical sympathetic ganglion (SCSG). Experiments were performed on 12 adult rabbits and a monkey. Under sodium pentobarbital anesthesia, 20 microliters of 10% HRP were injected slowly into the rabbit's SCSG. In the monkey, 20 microliters of 15% HRP was injected.After a postoperative survival time of 3～6 days, the animals were perfused through,the ascending aorta with a cold fixative mixture composed of 2% paraformaldehyde and 1.25% glutaraldyhyde in 0.1mol phosphatebuffer at pH 7.4. The spinal cord segments C_1～L_3 were cut serially in transverse plane on a cryostat at 48 micra.The HRP reaction product was demonstrated according to Mesulam's (1976) benzidine blue reaction method, and counterstained with neutral red.HRP labeled neurons in the spinal cord were located exclusively on the side ipsilateral to the injected SCSG. The total number of labeled cells were 7908 in 12 rabbits, but the number of labeled cells varied from animal to animal. The highest amount was 1690 (423~#) and the lowest amount was 71 (425~#). The longitudinal distribution of the labeled cells in 12 rabbits was 12 segaments of the spinal cord (C_6～T_9), but the largest proportion (86.18%) of them was concentrated from T_1 to T_4, especially at the level of T_2 and T_3 (56.22%), and with a peak at T_2 (29.10%).In cross section of the spinal cord. HRP-labeled cells were concentrated in four cell groups, they are: nucleus intermediolateralis pars principalis (ILp), nucleus intermediolateralis pars funicularis (ILf), nucleus intercalatus (IC) and nucleus intercalatus pars paraependymalis (ICpe). The latter is subdivided into dorsal portion and ventral portion. HRP positive cells were mainly located in the ILp, In 12 rabbits about 92.99% cells were located in it. A small portion of labeled cells(6.25%) were seen in the ILf. A few labeled neurons could be detected within,the IC (0.68%) and ICpe (0.08%). Furthermore, occasionally, very few labeled cells were found at the dorsol portion of the anterior horn.In the monkey, generally speaking, the pattern of the distribution of labeled cells was the same as the rabbit.