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Objective To explore clinical efficacy and safety of Wutou-Chishizhi decoction combined with conventional medicinefor treatment for ischemic cardiomyopathy and heart failure. Methods A total of 103 patients with ischemic cardiomyopathy and heart failure were divided into control group (n=51) and treatment group (n=52). Patients of control group were treated with conventional medicine, while treatment groupwere treated Wutou-Chishizhi decoction combined with conventional medicine. The two groups were treated for 28 days. Clinical curative effect was evaluated after treatment. The score of quality of life of the two groups were compared. The LVEDD, LVESD, LVEF, VEGF, hs-CRP, BNP and cTNⅠ of the two groups were compared. The adverse reactions of the two groups during the treatment were compared. Results Total effective rate of the treatment group was 94.23％(49/52), which was significantly higher than the control group 76.47％ (39/51), and the difference was statistically significant (χ2=6.527, P=0.011). After treatment, the LVEDD (50.25 ± 6.82 mm vs. 57.12 ± 7.33mm, t=4.926) and LVESD (44.13 ± 3.63 mm vs. 46.20 ± 4.05 mm, t=2.733) in the treatment group were significantly lower than those in the control group (P<0.05). The LVEF (45.57％ ± 7.30％ vs. 41.14％ ± 6.22％, t=3.312) in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, the VEGF in the treatment group was significantly higher than that in the control group (P<0.05). And the hs-CRP (2.11 ± 0.41 mg/L vs. 3.05 ± 0.63 mg/L, t=8.992), BNP (82.02 ± 21.13 pg/L vs. 122.35 ± 30.52 pg/L, t=7.810) and cTNⅠ (0.25 ± 0.08 μg/L vs. 0.37 ± 0.10 μg/L, t=6.732) in the treatment group were significantly lower than those in the control group (P<0.05). There were no serious adverse reactions of the two groups during treatment. Conclusions The Wutou-Chishizhi decoction combined with conventional medicine for treatment of ischemic cardiomyopathy and heart failure has a good efficacy and low adverse reactions, can improve the cardiac function and quality of life, reduce the serum hs-CRP, BNP and cTNⅠ levels, improve the serum VEGF level, and it was worthy clinical application.
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Objective To analyze the clinical features and prognosis of anti-leucine rich glioma inactivated protein 1 (LGI1) encephalitis.Methods Twelve encephalitis patients with anti-LGI1 antibodies were collected from the First Affiliated Hospital of Zhengzhou University from June 2015 to December 2016.The clinical manifestations,electroencephalogram,laboratory examination and imaging findings were summarized and the prognosis was observed.The modified Rankin Scale (mRS) was used for evaluation before and after treatment.Results The major clinical features included memory deficit (10/12),spatial disorientation (7/12),epilepsy with generalized tonic-clonic seizures (9/12),faciobrachial dystonic seizures (7/12),hyponatremia (5/12),mental and behavioral abnormalites (1/12),light sleep (1/12),increased sleep (3/12),aphasis (4/12),dysphagia,choking (2/12),headache (1/12),dizziness (2/12),fatigue (2/12),ataxia (2/12),bradycardia (3/12),urinary disorders (2/12),intestinal obstruction (1/12),diarrhea (1/12).Admission mRS score was found to be three in eight cases,four in four cases.The abnormal electroencephalogram was found in six cases,mainly manifested as focal or diffuse slow wave,some accompanied by epileptic wave.MRI scan of brain showed abnormal signals in four cases,mainly involved medial temporal lobe,hippocampus,basal ganglia,while one patient avoided MRI scan due to implantation of pacemaker.Two patients presented with pulmonary nodules,one case with positive thyroid antibody and increased rheumatoid factor.The follow-up after treatment showed no one died;mRS score was two in two cases,one in nine cases and zero in one case;the sequelae were memory deficit,increased sleep,faciobrachial dystonic seizures.Conclusions Anti-LGI1 encephalitis is a treatable disease,cardinal clinical features of which are seizures,cognitive disorders,hyponatremia.Immunotherapy can improve the symptoms of the disease significantly,and the prognosis is better comparatively.
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BACKGROUND:Shengjiyuhong ointment has been reported to inhibit hypertrophic scarring. OBJECTIVE:To verify the effects of Shengjiyuhong ointment on hypertrophic scarring of in a rabbit ear model. METHODS:Each ear of thirty-six Japanese rabbits was used to make four 1-cm-diameter circular ful-thickness skin wounds with the entire perichondrium removed. Final y, 288 wounds were made and randomly divided into 6 groups:model, negative control (no drugs were administered), low-, moderate-, high-crude herbal dose drugs (Shengjiyuhong ointment was administered topical y at concentrations of 8.39%, 25.18%, and 75.54%), and positive control (recombinant bovine basic fibroblast growth factor was administered topical y). Shengjiyuhong ointment was administered twice daily til wound healing. The wounds were evaluated by the Vancouver scar scale (VSS). Scar elevation index (SEI) of scar specimens was calculated under a microscope at 40× magnification. mRNA expression levels of type I and III col agen, connective tissue growth factor, fibronectin, andα-smooth muscle actin (α-SMA) were determined by fluorescent quantitative PCR. Protein expression levels of type I and III col agen andα-SMA were detected by western blot assay.α-SMA immunoreactivity was determined by immunofluorescent staining. RESULTS AND CONCLUSION:VSS scores and SEI were significantly increased in each group at 30 days (P<0.05). VSS scores and SEI were significantly decreased in the moderate-and high-crude herbal dose drug groups and positive control groups compared with the model, negative control, and low-crude herbal dose drug groups (P<0.05 or P<0.01). mRNA expression levels of type I and III col agen, connective tissue growth factor and fibronectin, and protein expression levels of type I and III col agen andα-SMA were significantly inhibited after moderate-crude herbal dose Shengjiyuhong ointment and positive drug treatment (P<0.01). These findings suggest that Shengjiyuhong ointment can reduce hypertrophic scars by inhibiting fibroblast proliferation and col agen deposition.
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Objective The aim of this study was to explore the clinical value of dual-source CT(DSCT)in the diagnosis of coronary artery fistula(CAF)before and after surgery. Methods A retrospective analysis was performed in 15 cases of patients with CAF,11 cases of which was treated by surgery during extracorporeal circulation. Results CAF arose from right coronary artery in 8 cases and left coronary artery in 7 cases,with the latter including 3 cases of ramus nodi sinuatrialis fistula,2 cases of anterior descending branch fistula,and 2 cases of left circumflex fistula. CAF entered into right atrium(6 cases),right ventricle(5 cases),left ventricle(4 cases)and left atrium(1 case). There were dilatation of coronary artery in 8 cases,localized aneurysm in 4 cases,normal coronary artery in 3 cases,single fistula orifice in 11 cases,and multiple fistula orifice in 4 cases. 11 patients underwent surgery under cardiopulmonary bypass(CPB).The postoperative imaging revealed fistula has been sutured in 10 patients with no residual fistula,including fistula vascular ligation in 3 cases,the proximal imaging and distal occlusion in right coronary artery angioplasty in 1 case,and pseudo diverticulum in 2 cases. Conclusion DSCT examination has significant value in preoperative diagnosis and postoperative follow-up for CAF.
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Since the beginning of 973 plans and major scientific research programs,the ministry of science and technology has organized the implementation of a number of major projects under the principle guidance of top-level design,co-ordinate arrangements,advantage integration and dynamic adjustment.Prominent advance of technology and expansion of innovation capacity has become possible with the success of those major projects.As a dominant force of basic science research,universities took part in the designing and implementing of most of 973 major scientific research programs.In this paper,participating universities,such as Peking University,Tsinghua University,Fudan University,Zhejiang University,Shanghai Jiaotong University,University of Science and Technology of China,Nanjing University,were analyzed in their roles played in those projects,and the questions of how universities should make the adjustment to their planning and management to meet the requirements of future national research programs were discussed.
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The State Key Specialized Scientific Projects bring the unprecedented opportunity for the development of variety disciplines and provide the critical timing for the improvement of science and technology of university. Meanwhile, it presents new challenges to develop the frontier of sciences and to promote cooperation and cross of different disciplines. Through the process of the programs, we will expect to train and find team leaders and outstanding scientists. This paper presented the brief outline how the researchers from the Departments of Infectious Disease and School of Pharmacy in Fudan University collaborated in a cross-discipline manner and integrated the research resources based on the objectives of the research programs. During the application, they reorganized research teams, combined the overlapping research fields to focus the direction of research fields according to the national and research needs. In the process of their application, they finally promoted the capacities for their competition and innovation which were undoubted to help us to establish headship/main forces in the fields of infectious disease precaution and devolvement of new clinical medicine in the future.
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This paper reviewed and analyzed the management and performance of 43 key clinical pmjeets in recent ten years in Fudan University(the clinical part of original Shanghai Medical University).It was found that hardware equipments of clinic,the ability of disease prevention,diagnosis and treatment obviously improved,the talent training and personnel structure received outstanding outcome,the academic level of basic researches got obvious promotion,the preponderant disciplines established gradually and consolidated,and the center radiation effect showed preliminary success under the aid of key project fund.Constructing the key clinical projects should boost actively amalgamation of medicine and sciences and pay a great attention to develop the medicine auxiliary discipline to further enlarge the clinical research achievements and fully display the guidance function for the development of our country~clinical medicine discipline under the new situation.
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<p><b>OBJECTIVE</b>To investigate the effect of chronic treatment of enbrel (EB), a TNF-alpha antagonist, in a well defined congestive heart failure (CHF) rat model and test the hypothesis that chronic treatment of EB in CHF rats may limit the progression of Left ventricular (LV) dysfunction and structure remodeling and decrease cardiac IL-1beta levels.</p><p><b>METHODS</b>We measured cardiac conformation, contractile performance and cytokines level in 8 age-matched normal adult rats (control group) and 8 rats with isoproterenol (ISO)-induced Heart failure (ISO group) and 8 rats with ISO-induced lesion but received EB treatment (EB group).</p><p><b>RESULTS</b>LV end diastolic diameter and LV end systolic diameter in EB group were significantly less and LV fractional shortening was significantly larger than ISO group (9.2 +/- 0.3 mm vs 9.5 +/- 0.2 mm, 5.8 +/- 0.5 mm vs 6.5 +/- 0.3 mm, 0.37 +/- 0.03 vs 0.31 +/- 0.02, P < 0.05, P < 0.01, P < 0.01 respectively , but there was no significant difference of LV posterior wall thickness at end diastole between the two groups; LV end systolic pressure (P(ES)) dp/dt(max) in EB group were significantly greater than ISO group (104.8 +/- 4.6 mm Hg vs 98.4 +/- 4.9 mm Hg, 8395 +/- 940 mm Hg/s vs 6898 +/- 612 mm Hg, P < 0.05 P < 0.01 respectively), and LV end diastolic pressure (P(ED)) dp/dt(min), time constant of LV relaxation were significantly lower than ISO group (3.8 +/- 0.6 mm Hg vs 7.1 +/- 0.8 mm Hg, -5963 +/- 475 mm Hg/s vs-5030 +/- 316 mm Hg/s,15.4 +/- 0.8 ms vs 21.3 +/- 1.4 ms, P < 0.01, respectively . Although cardiac contractile performance in the EB group was greatly improved, there still was a big gap when compared with the control group. The ratio of LV weight to body weight in the EB group was significantly higher than control group 2.82 +/- 0.07 mg/g vs 2.28 +/- 0.08 mg/g, P < 0.01 but there was no significant difference when compared with the ISO group. There was no significant difference between the serum level of TNF-alpha in EB group and ISO group the it could not be detected in control group. TNF-alpha levels in LV of EB group was significantly higher than control group, 757.6 +/- 46.8 pg/g vs 367.5 +/- 22.7 pg/g, P < 0.01 but there was no significant difference when compared with ISO group. The IL-1beta level in LV of EB group was significantly lower than ISO group 356.2 +/- 28.5 pg/g vs 518.4 +/- 32.5 pg/g, P < 0.05 and it could not be detected in control group. The serum level of IL-1beta could not be detected in any rats.</p><p><b>CONCLUSION</b>EB administered as soon as possible when ISO induced myocardial necrosis occurs can greatly improve cardiac contraction, and the improvement may be partly due to a decrease in the IL-1beta level in LV, besides the direct blocking effect of EB on TNF-alpha. EB can alleviate cardiac remodeling by its effect on LVEDD.</p>