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By preparing 15 batches of substance benchmarks of Taohong Siwu Decoction, the methodology of the characteristic spectrums of substance benchmarks was established. The paste-forming rate range, the contents and the transfer rate range of the index components, hydroxy safflower yellow A, ferulic acid and paeoniflorin, the characteristic peaks and the similarity range of the characteristic spectrums of Taohong Siwu Decoction were determined to define key quality attributes of substance benchmarks of Taohong Siwu Decoction.In the 15 batches of substance benchmarks of Taohong Siwu Decoction, the similarity of characteristic spectrums was higher than 0.9. Furthermore, based on summarization of the characteristic peak information, there were 13 characteristic peaks in the whole decoction. Baishao had three characteristic peaks, Honghua had seven characteristic peaks, and Chuanxiong and Danggui had three characteristic peaks. The paste-forming rate of the 15 batches of substance benchmarks was controlled at 33.11%-40.62%. The content of hydroxy safflower yellow A was 0.129%-0.203%, with the average transfer rate of 16.596%±0.669%.The content of ferulic acid was 0.043%-0.055%, with the average transfer rate of 20.489%±1.772%.The content of paeoniflorin was 0.676%-0.943%, with the average transfer rate of 29.112%±3.273%.The quality value transfer of substance benchmarks of classical prescription Taohong Siwu Decoction was analyzed by the combination of characteristic spectrums, paste-forming rate and the content of index components. The established substance benchmark quality evaluation method was stable and feasible, and could provide a basis for quality control and subsequent development of relevant preparations of Taohong Siwu Decoction.
Subject(s)
Benchmarking , Drugs, Chinese Herbal , Quality ControlABSTRACT
By preparing 10 batches of substance benchmarks freeze-drying powder( lyophilized powder),the methodology of the characteristic spectrum and the content of index component for substance benchmarks of Qingwei San was established. The characteristic peaks and the similarity range of the characteristic spectrum,the contents and the transfer rate range of isoferulic acid,palmatine and paeonol,and the paste-forming rate range were determined to define key quality attributes of substance benchmarks of Qingwei San. In the10 batches of substance benchmarks of Qingwei San,the similarity of characteristic spectrum was higher than 0. 90. In further comparison of the characteristic peak information,a total of 16 characteristic peaks were identified,including 5 characteristic peaks from Cimicifugae Rhizoma,5 characteristic peaks from Coptidis Rhizoma,2 characteristic peaks from Angelicae Sinensis Radix and 4 characteristic peaks from Moutan Cortex. The content of isoferulic acid was 0. 10%-0. 18%,with the average transfer rate of 49. 82%±4. 02%. The content of palmatine was 0. 17%-0. 31%,with the average transfer rate of 15. 84% ±2. 39%. The content of paeonol was 0. 41%-0. 75%,with the average transfer rate of 23. 41%±3. 23%. The paste-forming rate of the 10 batches of substance benchmarks were controlled at 27%-33%,with the transfer rate between the theoretical paste-forming rate and the actual paste-forming rate was 86. 59%±3. 39%. In this study,the quality value transfer of substance benchmarks of Qingwei San was analyzed by the combination of characteristic spectrum,the content of index component and the paste-forming rate. A scientific and stable evaluation method was preliminarily established,so as to provide the basis for subsequent development and quality control of relevant preparations of Qingwei San.
Subject(s)
Benchmarking , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Powders , Quality Control , RhizomeABSTRACT
OBJECTIVE@#To systematically evaluate the efficacy and safety of conventional therapy combined with moxibustion in the treatment of chronic obstructive pulmonary disease (COPD) in stable phase based on Meta-analysis medicine.@*METHODS@#The randomized controlled trials (RCTs) of moxibustion as adjuvant therapy for COPD were retrieved from the databases of CNKI, Wanfang, SinoMed, PubMed, Web of Science, Cochrane Library and Ebsco. RevMan5.3 software was used for Meta analysis, and the quality of evidence was evaluated according to GRADE standards.@*RESULTS@#A total of 16 RCTs were included, involving 1425 patients. The results of Meta-analysis showed that: compared with the conventional treatment, ①the adjuvant therapy with moxibustion had advantages in reducing the number of acute exacerbations [@*CONCLUSION@#The efficacy of moxibustion as adjuvant therapy for COPD in stable phase is better than that of simple conventional therapy. Due to insufficient clinical evidence and the limitations of this study, clinical safety is unclear and further evidence is needed to support the results.
Subject(s)
Humans , Lung , Moxibustion , Pulmonary Disease, Chronic Obstructive/therapy , Treatment OutcomeABSTRACT
This paper compared and analyzed the relevant records of Chinese medicine pharmacy in the Han,Tang and Song dynasties,and summarized the changes of the dosage forms,preparation techniques and administration methods of Chinese medicine with the development of history.In this study,three classic medical works in the Han,Tang and Song dynasties,including Treatise on Febrile Diseases Caused by Cold,Valuable Prescriptions for Emergency and Formularies of the Bureau of People's Welfare Pharmacies,were taken as the research objects,and the development of the dosage forms,auxiliary materials,preparation technology and medication theory were summarized and explored by the ways of content analysis,comparative analysis and case analysis.The comparison showed that in the development process,the dosage forms gradually increased,but the liquid dosage forms gradually decreased,the solid dosage forms gradually increased.Not only the dosage forms varied in the number,types of excipients used more and more,but the level of preparation had been constantly improved while the methods of taking became more detailed.This evolution of dosage forms and pharmaceutical technologies in Chinese history is worth learning and thinking about it.Through exploring the traditional Chinese medicine(TCM) technologies and theories in the Han,Tang and Song dynasties,we can contribute to the inheritance of traditional preparations and it can provide the basis for the development of modern preparations with TCM characteristics.
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Protein kinase Cε (PKCε) is a transforming oncogene and plays an important role in many cellular processing. In the present paper, we review the development of experimental researches on the acute-chronic pain transformation. Results indicated that prostaglandin E2 (PGE2) / EP1 receptor-Gq-PKCε is an important signaling pathway to modulate chronic pain in peripheral dorsal root ganglion (DRG) neurons, and also plays a role in the later stage of hyperalgesia during transformation from acute to chronic pain. PKCε in DRG neurons induces mechanical and thermal hypersensitivity respectively by over expression of transient receptor potential vanilloid 1 (TRPV1) and TRP ankyrin-1 (TRPA1), further mediating the transformation from acute to chronic pain. Whereas, PGE2-evoked activation of EP1-Gq-PKCε signaling may be the key link in initiating the pain translation process through regulating downstream TRPA1 and TRPV1. Electroacupuncture (EA) has been used to effectively relieving various types of acute and chronic pain for decades, and can significantly inhibit the expression of PKCε and its upstream and downstream molecules. Therefore, it can be inferred that there exists a possibility of EA interventions in interfering the transformation from acute to chronic pain by regulating peripheral PKCε signaling pathway.
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ATG5 and BECLIN-1 belong to two kind of crucial autophagy-related proteins included the formation of autoph-agosomes,in addition to the promotion of autophagy,enhances susceptibility towards apoptotic stimuli,therefore,ATG5 and BECLIN-1 are considered to be a molecular link between autophagy and apoptosis.Preliminary data revealed that ATG5 media-ted the formation of autophagosomes by ATG5-ATG12-ATG16L ubiquitination system,while BECLIN-1 induces autophagy by phosphatidylino3-kinase (PtdIns3KC3)complex.But now it is believed that truncated ATG5(tATG5-N)and truncated BEC-LIN-1(BECLIN-1-C),an amino-terminal cleavage product of ATG5 and carboxyl-terminal cleavage product of BECLIN-1, could induce apoptosis.The research summarize the progress on ATG5 and BECLIN-1 regulated autophagy and apoptosis,so as to further reveal the molecular mechanism of they regulate autophagy and apoptosis.
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BACKGROUND: It is quite difficult to produce a decellularized lung scaffold, in which cells are removed and the extracellular matrix components (ECM) are preserved effectively. Perfusion of detergent-enzymes is an effective method with wide applications for decellularized lung scaffolds. OBJECTIVE: To investigate the effects of two detergents (sodium deoxycholate, SDC and sodium dodecyl sulfate, SDS) on the preparation of decellularized lung scaffolds. METHODS: Twenty-four male Sprague-Dawley rats were randomized into three groups: control group with no intervention, SDC group and SDS group. Decellularized lung scaffolds were prepared by perfusion of SDC or SDS combined with enzymes. The rat lung tissues in the three groups were taken for histological staining, immunofluorescent staining and DNA quantification. A549 cells were cultured and seeded onto the decellularized lung scaffolds for 7 days followed by hematoxylin-eosin staining. The decellularized lung scaffolds prepared by perfusion of SDC or SDS were subcutaneously implanted into the rat back, and the implants were retrieved and assessed by Masson staining after 2 weeks. RESULTS AND CONCLUSION: In the control group, there were abundant cells in the lung tissues. In the other two groups, the decellularized lung scaffolds were nearly transparent, and the morphology of the SDC scaffold was more close to the native lung. There were no residual cells and nuclei on the two scaffolds, and the DNA content in the SDS and SDC groups was significantly lower than that in the control group (P＜ 0.01). At 7 days of culture, A549 cells cultured on the SDS and SDC scaffolds migrated from the edge to the center of the scaffold. Comparatively speaking, the migration ability of A549 cells on the SDC scaffolds was stronger, and there was obvious cell invasion and growth in the middle part of the lung. After 2 weeks of scaffold transplantation, the SDC implants poorly fused with the surrounding tissues, with a clear boundary, a large number of infiltrating cells distributed evenly, and intravascular blood cells were clearly visible; the number of new blood vessels with larger diameter in the SDC scaffold was significantly higher than that in the SDS scaffold. These findings indicate that the SDC scaffold has better biocompatibility than the SDS scaffold, which can fuse with the surrounding tissues faster and produce more infiltrating cells and new blood vessels.
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Objective To explore the elderly stroke patients into Maslow's hierarchy of needs theory to carry out the effect of nursing intervention on the Barthel and self efficacy, quality of diagnosis and treatment of this kind of special group that the accumulation of evidence-based care experience. Methods Eighty-two cases of elderly patients with stroke in our hospital from September 2015 to March 2017, with the random number table as the grouping criterion, will meet the inclusion criteria of the object is divided into study group and control group, 41 cases in each group. The control group received traditional nursing care, while the research group introduced the Maslow hierarchy of needs theory to intervene. The two groups of patients were evaluated before and after treatment, and the neurological function level, daily living ability, complication rate and nursing satisfaction were compared. Results After treatment, the score of basic knowledge, poor dietary harmful cognition, treatment knowledge, self-management knowledge and complication prevention knowledge were (2.3 ± 0.6), (2.4 ± 0.7), (2.3 ± 0.7), (2.5±0.7), (2.6±0.8) points respectively in study group, and (1.4 ± 0.4), (1.5 ± 0.4), (1.4 ± 0.4), (1.6 ± 0.5), (1.7 ± 0.5) points in control group. The difference was statistically significant (t=8.175-15.260, P<0.05).Neurological deficits after treatment in the study group were (7.8 ± 1.1) points lower than those in the control group (14.5±2.2) points. Barthel index was (61.5±5.4) higher than that in the control group (41.3± 4.0). The length of stay in hospital was (16.3±2.6) d, which was shorter than that in control group (25.3± 3.2) d, the difference was statistically significant (t=15.260, 12.352, 8.367, P<0.05). The complication rate was 9.8％ (4/41) in the study group, which was lower than 29.3％ (12/41) in the control group. The satisfaction rate in the study group was 97.6％(40/41), which was higher than 82.9％(34/41) in the control group), the difference was statistically significant (χ2=13.279, 13.267, P<0.05). Conclusions For elderly stroke patients, nursing intervention into Maslow's hierarchy of needs theory, help to improve their self-efficacy and nerve function level, and can improve the nursing satisfaction, is worthy of further promotion.
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The classic BCR-ABL negative myeloproliferative neoplasm (MPN) comprise polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). These three disorders are characterized by stem cell-derived clonal myeloproliferation and presence of somatic mutations. The WHO diagnostic criteria for the classic BCR-ABL negative MPN has been revised in the 2008 edition by incorporating new information about their molecular pathogenesis. Robust prognostic system for PMF has already done, and those for PV and ET are under discussion. Treatment with novel drugs is promising, and allo-stem cell transplantation (allo-ASCT) is the only curative treatment for myelofibrosis, however, the patient selection and management before transplant have been discussed for a long time.
Subject(s)
Humans , Fusion Proteins, bcr-abl , Myeloproliferative Disorders , Polycythemia Vera , Primary Myelofibrosis , Prognosis , Thrombocythemia, Essential , World Health OrganizationABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical and laboratorial features of primary myelofibrosis (PMF) patients treated in our hospital, to analyze the risk factors influancing survival, and to compare several prognostic scoring systems.</p><p><b>METHODS</b>parameters about clinical and laboratorial features were taken from medical documents at diagnosis, univariate analysis was conducted by Kaplan-Meier method, the survival data were compared with Log-rank test, and a COX model was used for multivariate analyses.</p><p><b>RESULTS</b>In our center the anemia and JAK2V617F mutation were more common, while the abnormal karyotype was less common, the constitutional symptoms, splenomegaly, Hb level < 100 g/L and LDH are adverse factors for survival in univariate analysis. Constitutional symptoms and Plt count < 100 × 10(9)/L are adverse factors of survival according to multivariate analysis.</p><p><b>CONCLUSION</b>The anemia is more frequent in Chinese patients. Constitutional symptoms and Plt count < 100 × 10(9)/L are independent risk factors for survival. LILLI, modified IPSS, modified DIPSS are suitable to our data.</p>
Subject(s)
Humans , Abnormal Karyotype , Asian People , Janus Kinase 2 , Mutation , Primary Myelofibrosis , Prognosis , Risk FactorsABSTRACT
OBJECTIVE:To provide for rational use of Tripterygium glycosides tablet clinically. METHODS:The utilization of Tripterygium glycosides tablet were collected from hospital information system(HIS)in our hospital during Jun. 2012-Jun. 2014. Then the data about the basic information,patients’age,departments and diagnosis,were analyzed by the Excel. RESULTS:The application of Tripterygium glycosides tablet remained stable since Jun. 2012. There were 4 600 prescriptions in average every year, and the age of patients was distributed from 11 to 90. Tripterygium glycosides tablet was mainly used in rheumatology department (52.11%),followed by TCM rheumatology department(20.62%),skin disease and venereal disease department(18.15%),ne-phrology department(3.52%)and integrated traditional and western medicine cardiology department(1.77%). It was mainly used to treat rheumatoid arthritis,Sjogren's syndrome,polymyalgia rheumatica,osteoporosis and nephrotic syndrome. CONCLUSIONS:The application of Tripterygium glycosides tablet as immunosuppressant is widely used,but the age of patient is with wide distribu-tion;the narrow gap exists between minimum effective dose and minimum lethal dose;so ADR should be concerned closely.
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<p><b>OBJECTIVE</b>To study the curative effect of Zhiyang Pingfu Liquid (ZPL) in treating epidermal growth factor receptor inhibitors (EGFRIs) associated adverse reactions of the skin.</p><p><b>METHODS</b>All 54 patients with pathologically confirmed malignant tumor had EGFRIs induced adverse reactions of the skin to various degrees. ZPL was externally applied for them all, once or twice per day, 14 days consisting of one therapeutic course. Changes of adverse skin reactions, time for symptoms relief, adverse skin reaction types suitable for ZPL were observed before and after treatment.</p><p><b>RESULTS</b>EGFRIs associated skin adverse reactions were improved to various degrees after they used ZPL. The shortest symptoms relief time was 1 day while the longest was 12 days, with an average of 6.93 days and the median time 7 days. Compared with before treatment, itching, rash/scaling, acne/acneform eruptions were obviously improved (P < 0.05).</p><p><b>CONCLUSION</b>ZPL could alleviate EGFRls associated adverse skin reactions, especially showed better effect on itching, rash/scaling, acne/acneform eruptions.</p>
Subject(s)
Humans , Antineoplastic Agents , Biomedical Research , Drugs, Chinese Herbal , Therapeutic Uses , Exanthema , Neoplasms , Drug Therapy , Pruritus , ErbB Receptors , Skin , Skin Diseases , Drug TherapyABSTRACT
[Objective] To observe the effect of fluoride foam on dental caries increment in primary teeth, and provide the basis for prevention and control of children's dental caries. [ Methods] Three hundred and thirty-five children were included randomly from junior classes of 4 kindergartens as experi-mental group , and another 268 children from junior classes of another 4 kindergartens as control group .The experimental group used 1.23%fluoride foam twice a year , and the control group did not have any inter-ventions.The two groups of children were followed up for 3 years, and examined for the situation of their caries detection rate and average risk of caries , and for evaluation of the effect of fluoride foam in prevention of children's dental caries . [ Results] Caries detection rate in the two groups increased with age .After 3 years, caries detection rate in control group increased by 34.05%and in experimental group increased by 22. 19%.The use of fluoride foam reduced 10.89%caries disease for experimental group .Caries detection rates were 55.62%in experimental group and 66.51%in control group .The difference in detection rate was sig-nificant between experimental group and control group (P<0.05).Average caries in experimental group was 3.4 ±4.38 after 3 years, and 4.7 ±4.80 in control group.There was a significant difference in average caries between the two groups (P<0.05). [Conclusion] Application of 1.23%fluoride foam was effective in reducing the increment of dental caries in primary teeth , and it is worth promoting in the kindergartens .
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OBJECTIVE: To investigate the effects of Jianpisanjie (JPSJ) pills on the gastro-intestinal functions by animal experiment. METHODS: With gastric evacuation and gastrointestinal propulsion movement of mice obstructed by atropine sulphate, and the emesis of pigeon resulted by copper sulfate, the effects of JPSJ on gastrointestinal function was investigated, the effects on vomit latent period and emesis times were also studied. The model of hepatoma H22 bearing mice was established. After weighting, the mice were randomized into 5 groups, they were the control group, the high, middle, low dosages of JPSJ, and the positive-control group. Then they were treated with chemotherapy and administrated with subject drugs. When the trial ended, the weight and food intake of H22 bearing tumor were determined. RESULTS: Different dosage of JPSJ could increase the gastric evacuation rate and gastrointestinal propulsion rate, prolong the vomit latent period and emesis times of pigeon. And the pills also could reduce the side-effects of chemotherapy, such as weight of mice and food intake. CONCLUSION: JPSJ could promote the gastro-intestinal function, improve the weight loss and less food intake resulted by chemotherapy, and may be adjuvant drug for tumor.
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Objective To investigate the correlation between various types of atrial tachycardia (AT) and tachycardia-induced cardiomyopathy(TIC) in children and to assess the risk factors for the development of TIC.Methods Patients with AT were divided into 2 groups depending on whether complicated with TIC or not,defined as left ventricular ejection fraction(LVEF) ＜ 50％ on echocardiography.The presence of atrial rhythm in Holter monitoring,ventricular rate of AT,and the type of AT onset were compared between the 2 groups; the risk factors associated with TIC were also analyzed.Results Totally 72 patients were enrolled in this study.The incidence of TIC was 23.6％.The incidence of TIC in patients presenting incessant tachycardia was significantly higher than that of patients presenting paroxysmal tachycardia(53.6％ vs 4.5％,P ＜ 0.01).Patients with TIC had a higher mean atrial rhythm percent [(98 ± 5) ％ vs (37 ± 4) ％,P ＜ 0.001] and faster mean ventricular rate [(134.25 ± 19.24) beats/min vs (100.03 ± 18.83) beats/min,P ＜ 0.05] compared with those without TIC.After successful control of tachycardia,LVEF in patients with TIC gradually recovered within 6 to 75 days [(29.44 ± 21.62) days].Conclusions An incessant AT with higher percent of atrial rhythm and faster mean ventricular rate is more frequently complicated by cardiomyopathy.Recovery of TIC can be achieved after successful control of AT.Early intervention and treatment should be performed for those with high risk factors for the development of TIC.
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Objective To investigate the success rate,factors associated with recurrence,safety and effect of age on results of radiofrequency catheter ablation(RFCA) for different types of tachyarrhythmias in children.Methods A thousand children diagnosed as tachyarrhythmias underwent electrophysiological study (EPS),with mean age (7.6 ±3.8) years old(0.33-16.50 years old).RFCA methods and results for different kinds of tachyarrhythmias along with recurrence and complications were analyzed.RFCA results for different age groups were compared.Results A thousand children underwent EPS.The number of atrioventricular reentrant tachycardia(AVRT) was 560 (56％),atrioventricular nodal reentrant tachycardia (AVNRT) was 210 (21％),ventricular tachycardia/ventricular premature contraction (VT/PVC) was 159 (15.9％),focal atrial tachycardia (FAT) was 49 (4.9％),and atrial flutter/incisional reentrant atrial tachycardia (AF/IRAT) was 22 (2.2％).Totally 958 children underwent RFCA,among whom success rate was 96.2％ and recurrence rate was 8.1％.EPS performed on recurred cases showed restoration of primary pathway/origin was 5.3％,while appearance of new pathway/origin was 2.8％.Five hundred and thirty-three AVRT cases underwent RFCA,among whom success rate was 98.0％,recurrence rate was 8.4％,restoration of primary pathway was 4.0％,and appearance of new pathway was 4.4％.Success rate of right anterior/mid septal pathway was relatively low (85.3 ％),but its rate of restoration of primary pathway was high (31.0％),as 205 cases of AVNRT underwent RFCA,among whom success rate was 100％,recurrence rate was 5.9％,and restoration of primary origin was 4.9％,while 22 cases of AF/IRAT underwent RFCA,among whom success rate was 95.5％ with no recurrence,46 cases of FAT underwent RFCA,in which success rate was 84.8％ ; success rates for two-dimensional mapping group and three-dimensional mapping combined with cool-tip ablation group were 62.5％ and 96.7％ respectively and the difference was significant (P ＜ 0.05),as 10 cases recurred in which 7 originated from atrial appendages,and these 7 cases were successfully cured by appendectomy,152 cases of VT/PVC underwent RFCA,in which success rate was 89.5％,recurrence rate was 6.6％,restoration of primary origin was 5.9％.There was no difference in success rate between different age groups.The gross success rates and success rates for different types of arrhythmias between early and late periods were not different,while recurrence rates for AVNRT and left anterior pathways in early periods were significantly higher than late periods(P ＜0.05).There were totally 8 cases with complications(0.84％),including 2 cases of complete atrioventricular block and 1 case of anesthetic accident which happened in early period.The other 5 were vascular complications,and there was no death.Conclusions RFCA can be safely used as frontline treatment to cure some kinds of tachyarrhythmias in children with high success rate and low recurrence rate.There is no difference in rates of success,recurrence and complication between younger and older children,while difficulty for procedure increased for the former so that caution should be made for selection of patients.Application of three-dimensional mapping for difficult arrhythmias can increase success rate for ablation.Proficient experience and skillful manipulation are the main factors to avoid complications.
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<p><b>OBJECTIVE</b>To investigate the feasibility, advantages and efficacy of implantation of left atrial and ventricular epicardial dual chamber pacemaker to treat pediatric complete atrioventricular block.</p><p><b>METHOD</b>Eleven children with median age 4.0 years (0.5-7.6 years) diagnosed as complete atrioventricular block resisting to drug therapy received implantations of left atrial and ventricular epicardial dual chamber pacemakers. Six were male and five female. Temporal or permanent right ventricular pacing was used for all of them before implantation of left atrial and ventricular epicardial dual chamber pacemakers. Three cases showed cardiac dysfunction. Left lateral thoracotomy was performed at 4th intercoastal space along anterior axillary line under general anesthesia, the pericardium was incised vertically anterior to the phrenic nerve, two pacing leads were individually located at left atrial appendage and left ventricular lateral wall. After all the parameters were detected to be satisfactory, a pouch was made at left abdomen under coastal margin. Dual chamber pacemaker was connected with pacing leads through subcutaneous tunnels. The sizes of heart chambers, cardiac functions, parameters of pacemaker, sensitivity, pacing status, PR interval and QRS interval were closely followed up post-operatively.</p><p><b>RESULT</b>Implantations of pacemakers were successful for all of the patients with no complications associated with operations. Preoperative electrocardiograms showed QRS interval (180 ± 33)ms under right ventricular pacing, it decreased to (140 ± 24)ms after implantation of left atrial and ventricular epicardial dual chamber pacemaker, significantly lower than right ventricular pacing (t = 8.8, P < 0.05) . Atrioventricular (AV) interval was set at 90 ms, PR interval (124 ± 4)ms. Echocardiograms performed within 2-3 days after implantation of left atrial and ventricular epicardial dual chamber pacemakers showed that for the 3 cases who were previously under right atrial and right ventricular dual chamber pacing presenting cardiac dysfunction, their left ventricular diastolic diameter (LVDd) decreased from (46.3 ± 12.5) (32.0-55.0) ms to (44.7 ± 12.0) (31.0-53.0) mm and left ventricular ejection fraction (LVEF) increased from 30% ± 15% (18%-47%) to 44% ± 18% (33%-65%). During 2-14 months' follow up, LVEF increased progressively which became significantly higher than before (65% ± 8% vs. 30% ± 15%, t = 5.6, P < 0.05) . Cardiac chamber sizes and left ventricular systolic function for the other 8 patients maintain normal during follow up. Pacing status and sensitivity were satisfactory for all these patients during follow up.</p><p><b>CONCLUSION</b>Implantation of left atrial and ventricular epicardial pacemaker might be considered for children diagnosed as complete atrioventricular block for whom endocardial pacemaker could not be implanted, due to its utmost protection for cardiac function with minimal injury and its ability to prevent or reverse pacemaker syndrome. Left atrial and left ventricular epicardium should be regarded as the first-choice and routine locations for epicardial pacing.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Atrioventricular Block , Therapeutics , Cardiac Pacing, Artificial , Methods , Electrodes, Implanted , Equipment Design , Feasibility Studies , Follow-Up Studies , Heart Atria , Heart Defects, Congenital , Heart Ventricles , Pacemaker, Artificial , Stroke Volume , Thoracotomy , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of iloprost in acute vasodilatation test during cardiac catheterization and to explore a useful hemodynamic indication regarding operability in the patients with severe pulmonary hypertension (PH) related to congenital heart disease (CHD).</p><p><b>METHODS</b>The clinical data of 46 patients [mean age (12 ± 9) years] with severe PH related to CHD from June 2006 to December 2008 was retrospectively analyzed. All patients underwent standard right and left cardiac catheterization and a trial of inhaled iloprost test during cardiac catheterization. The mean pulmonary arterial pressure was (80 ± 13) mm Hg (1 mm Hg = 0.133 kPa) and pulmonary vascular resistance index was (17 ± 10) wood.m². A positive response to inhaled iloprost was defined as a decrease of at least 20% in pulmonary vascular resistance index (PVRI) without changes on systemic artery pressure. Patients with positive response to iloprost underwent cardiac surgical repair. The pulmonary artery pressure and PVRI was monitored by Swan-Ganz catheter postoperatively.</p><p><b>RESULTS</b>Of the 46 patients, 29 (63.1%) showed a positive response after iloprost inhalation, defined by a significant reduction in PVRI from (15 ± 6) wood.m(2) at baseline to (9 ± 4) wood.m² in response to iloprost inhalation therapy (P < 0.05). The ratio of pulmonary to systemic resistance (Rp/Rs) decreased from 0.7 ± 0.2 to 0.4 ± 0.2 (P < 0.05). Seventeen patients (36.9%) didn't respond to iloprost displayed only little changes in PVRI [from (21 ± 10) wood.m(2) to (19 ± 9) wood.m²] and Rp/Rs (from 1.0 ± 0.5 to 0.9 ± 0.5). Out of 29 positive patients, 21 (72%) underwent successful cardiac surgical repair with a reduction of mean pulmonary arterial pressure (mPAP) to an average of (27 ± 10) mm Hg after the operation. Only 2 patients out of the 17 patients from the negative group were referred to surgery. Their mPAP was greater than 45 mm Hg.</p><p><b>CONCLUSIONS</b>A significant reduction in pulmonary artery pressure after cardiac surgery was observed in patients with positive response to inhaled iloprost. Inhaled iloprost may be a valuable tool in the preoperative evaluation of patients with severe PH related to CHD.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Young Adult , Administration, Inhalation , Heart Defects, Congenital , General Surgery , Hemodynamics , Hypertension, Pulmonary , General Surgery , Iloprost , Pharmacology , Lung , Preoperative Care , Retrospective Studies , Vasodilator Agents , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To objectively assess the clinical efficacy and safety of a new Pulian Ointment (, NPLO) in treating psoriasis of blood-heat syndrome of Chinese medicine.</p><p><b>METHODS</b>A total of 108 patients with psoriasis of blood-heat syndrome were equally assigned, using a randomizing digital table, to the test group treated externally with NPLO and the control group treated with placebo; the medication was done using a singleblinded method twice a day. Meanwhile, all patients received by oral intake a conventional Chinese decoction for clearing heat and cooling blood; the therapeutic course was 4 weeks for both groups. The therapeutic efficacy, changes in the Psoriasis Area and Severity Index (PASI) score and various aspects of the lesion, including scaly eruption, erythema, infiltration, size, score of itching as well as adverse reactions were observed.</p><p><b>RESULTS</b>The trial was completed in 100 patients, 51 in the test group and 49 in the control group. The remarkably effective rate was 45.10% and the total effective rate was 84.31% in the test group, which were significantly higher than those in the control group, 12.24% and 51.02%, respectively, showing a significant difference between groups (P<0.01). The test group also showed better effects in the improvement of the PASI score of the lesions and scores on erythema, infiltration, size of lesion as well as itching. No adverse event was found in either group.</p><p><b>CONCLUSION</b>NPLO is a Chinese remedy for the external treatment of psoriasis of the blood-heat syndrome with a reliable therapeutic efficacy and good safety.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Drugs, Chinese Herbal , Therapeutic Uses , Ointments , Psoriasis , Drug Therapy , SyndromeABSTRACT
<p><b>OBJECTIVE</b>To examine modulations caused by cyclooxygenase-2 (COX-2) inhibitors on altered microenvironments and overbalanced neurotransmitters in pilocarpine-induced epileptic status rats and to investigate possible mechanisms.</p><p><b>METHODS</b>Celecoxib (a COX-2 inhibitor) was administered 45 min prior to pilocarpine administration. The effects of COX-2 inhibitors on mIPSCs (miniature GABAergic inhibitory postsynaptic currents) of CA3 pyramidal cells in the hippocampus were recorded. Expressions of COX-2, c-Fos, newly generated neurons, and activated microgliosis were analyzed by immunohistochemistry, and expressions of alpha-subunit of gamma-amino butyric acid (GABA(A)) receptors and mitogen-activated protein kinase/extracellular signal-regulated protein kinase (MAPK/ERK) activity were detected by Western blotting.</p><p><b>RESULTS</b>Pretreatment with celecoxib showed protection against pilocarpine-induced seizures. Celecoxib prevented microglia activation in the hilus and inhibited the abnormal neurogenesis and astrogliosis in the hippocampus by inhibiting MAPK/ERK activity and c-Fos transcription. Celecoxib also up-regulated the expression of GABA(A) receptors. NS-398 (N-2-cyclohexyloxy-4-nitrophenyl-methanesulfonamide), another COX-2 inhibitor, enhanced the frequency and decay time of mIPSCs.</p><p><b>CONCLUSION</b>The COX-2 inhibitor celecoxib decreased neuronal excitability and prevented epileptogenesis in pilocarpine-induced status epilepticus rats. Celecoxib regulates synaptic reorganization by inhibiting astrogliosis and ectopic neurogenesis by attenuating MAPK/ERK signal activity, mediated by a GABAergic mechanism.</p>