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ObjectiveThis study analyzed the outcome indicators in randomized controlled trials （RCTs） on traditional Chinese medicine （TCM） treatment of vertigo， aiming to provide a reference for clinical trial protocol design and the establishment of core indicator sets for vertigo treatment. MethodCNKI， Wanfang， VIP， SinoMed， PubMed， Embase， and Web of Science were searched for the RCTs on TCM treatment of vertigo， and data extraction was conducted. ResultA total of 375 RCTs involving 33 593 patients were included， from which 482 outcome indicators were extracted， with a frequency of 2 715 and an average of seven outcome indicators used for each RCT. In addition， there were some differences in outcome indicators reported by different study groups. According to the functional properties， the reported outcome indicators were classified into nine domains： clinical symptoms and signs， TCM symptom efficacy， physical and chemical examinations， quality of life， mental health， safety events， patients’ satisfaction degree， long-term prognosis， and economic evaluation. The outcome indicators with higher frequency were clinical total effective rate， total TCM symptom score， occurrence of adverse reactions， dizziness handicap inventory （DHI） score， average flow velocity of the basilar artery， incidence of adverse reactions， average flow velocity of the left vertebral artery， average flow velocity of the right vertebral artery， plasma viscosity， and vertigo score. ConclusionThe outcome indicators reported by RCTs of TCM treatment of vertigo mainly have two problems： lack of unified standards and norms and insufficient attention to outcome indicators that can reflect the characteristics of TCM. The construction of the core indicator set for TCM treatment of vertigo should fully highlight the characteristic advantages of TCM and unify the standards and norms for the outcome indicators on this basis， so as to improve the quality of clinical research and the value of secondary research.
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Objective:To investigate the postoperative analgesic efficacy of nabuprofen combined with femoral nerve block in older adult patients subjected to knee arthroplasty and its effects on cognitive function and serum S-100β protein level.Methods:Ninety-one older adult patients subjected to knee arthroplasty between March 2018 and March 2020 in Zhoushan Hospital of Traditional Chinese Medicine were included in this study. They were randomly divided into observation ( n = 45) and control ( n = 46) groups. Patients in both groups received femoral nerve block and catheterization. Naborphine and equal amount of 0.9% sodium chloride injection were intravenously administered in the observation and control groups, respectively for postoperative analgesia. Before and after surgery, Mini-Mental State Examination (MMSE) score, S-100β protein level and Visual Analogue Scale score, and adverse reactions were compared between the observation and control groups. Results:Before surgery, there was no significant difference in MMSE score between the two groups ( P > 0.05). At 3 days after surgery, MMSE score in each group was significantly decreased compared with before surgery (both P < 0.05). At 3 days after surgery, MMSE score in the observation group was significantly higher than that in the control group [(25.34 ± 1.31) points vs. (23.67 ± 1.53) points, t = 5.34, P < 0.05]. Before surgery, there was no significant difference in serum S-100β protein level between the two groups ( P > 0.05). At 1 and 3 days after surgery, serum S-100β protein level in each group was significantly increased compared with before surgery (both P < 0.05). At 7 days after surgery, serum S-100β protein level in each group recovered to pre-operative level. At 1 and 3 days after surgery, serum S-100β protein level in the observation group was significantly lower than that in the control group ( t = 10.20, 9.21, both P < 0.05). At 1, 3, 6, 12 and 24 hours after surgery, the Visual Analogue Scale score in the observation group was (1.14 ± 0.22) points, (1.43 ± 0.25) points, (1.87 ± 0.21) points, (3.56 ± 0.20) points, and (2.63 ± 0.23) points respectively, which was significantly lower than that in the control group [(2.53 ± 0.24) points, (2.53 ± 0.24) points, (3.56 ± 0.20) points, (3.98 ± 0.25) points, (4.23 ± 0.21) points, t = 5.10, 8.15, 9.41, 10.18, 11.42, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [13.33% (6/45) vs. 30.43% (14/46), χ2 = 3.88, P = 0.049]. Conclusion:Naborphine combined with femoral nerve block can effectively improve the postoperative cognitive function of older adult patients undergoing knee arthroplasty, provides good postoperative analgesia, and is highly safe.
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Objective:To compare the analgesic effects of naborphine and desorine after surgery for supracondylar fracture of humerus in children.Methods:Eighty-seven children with supracondylar fracture of humerus who received surgical treatment in Zhoushan Hospital of Traditional Chinese Medicine between January 2019 and January 2020 were included in this study. They were randomly assigned to receive postoperative analgesia either with dezocine (control group, n = 44) or naborphine (observation group, n = 43). The postoperative agitation score, postanesthetic recovery score, postoperative visual analogue scale score, and adverse reactions were determined between the two groups. Results:The heart rate and mean arterial pressure at the time of extubation were (102 ± 7) beats/min and (83 ± 6) mmHg respectively in the observation group, which were significantly lower than those in the control group [(115 ± 8) beats/min, (92 ± 7) mmHg, t = 6.214, 8.283, P < 0.05]. In the observation group, the postoperative agitation score was (4.45 ± 0.34) points, (5.02 ± 0.38) points, and (3.65 ± 0.39) points, at the time of spontaneous eye opening, at the time of extubation and at 30 minutes after extubation respectively, which were significantly lower than those in the control group [(5.31 ± 0.48) points, (5.75 ± 0.35) points, (4.12 ± 0.37) points, t = 6.392, 7.194, 7.382, all P < 0.05]. At 30 min, 3 h and 6 h after surgery, the visual analogue scale scores in the observation group were significantly lower than those in the control group ( t = 5.345, 6.124, 7.553, P < 0.05). The time to return to spontaneous breathing, the time to spontaneous eye opening and the time to extubation in the observation group were (7.32 ± 4.17) min, (11.65 ± 3.32) min, (12.13 ± 2.41) min, respectively, which were significantly shorter than those in the control group [(10.34 ± 4.15) min, (14.43 ± 3.18) min, (15.16 ± 2.23) min, t = 7.216, 5.382, 7.319, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [6.97% (3/43) vs. 27.27% (12/44), χ2 = 6.280, P < 0.05]. Conclusion:Naborphine for analgesia after surgery for supracondylar fracture of humerus in children can effectively reduce the incidence of agitation during the recovery period, enhance postoperative analgesic effect, and lower the incidence of reverse reactions.
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<p><b>OBJECTIVE</b>To observe the regional homogeneity (ReHo) of resting-state brain function in the healthy subjects of gastric distention treated with acupuncture at the back- and front- points of the stomach, Weishu (BL 21) and Zhongwan (CV 12) and the correlation with gastric motility so as to explore the mechanism on the central integration of the front- and back- points of the stomach.</p><p><b>METHODS</b>The crossover test design was adopted. Twenty-four healthy subjects were assigned to a Weishu group, a Zhongwan group and a combined-point group separately, 8 cases in each one in each of the three times. Totally, 24 subjects were included in each group. Under the water load condition, the subjects received acupuncture at Weishu (BL 21), Zhongwan (CV 12) and the combined Weishu (BL 21) and Zhongwan (CV 12). Before and after each acupuncture, the resting-state brain functional magnetic resonance imaging (fMRI) scan and electrogastrogram (EGG) test were applied. The ReHo value was calculated in the collected fMRI imaging data. The changes in ReHo values were analyzed and compared before and after acupuncture in each group, as well as among the groups. The gastric motility was analyzed before and after acupuncture. Additionally, the correlative analysis was conducted between the gastric motility and ReHo changes before and after acupuncture.</p><p><b>RESULTS</b>(1) After acupuncture, EGG amplitudes in the subjects of each group were lower remarkably as compared with those before acupuncture (all <0.01). The EGG frequencies were not different significantly as compared with those before acupuncture (all >0.05). The EGG amplitudes in the Weishu group and the Zhongwan group were higher than those in the combined-point group (both <0.05). (2) As compared with the conditions before acupuncture, acupuncture at the combined front- and the back- points as well as Weishu (BL 21) and Zhongwan (CV 12) separately all induced the changes in the brain ReHo. Acupuncture at the combined front- and the back- points significantly increased Reho values in the right inferior temporal gyrus, the left thalamus, the precuneus and the posterior cingulate gyrus (all <0.05) and remarkably reduced the ReHo values in the the middle temporal gyrus of the right temporal pole, sulcus calcarinus and precuneus (all <0.05). Compared with the single point groups, acupuncture at the combined front- and the back- points induced the increase of ReHo value in the posterior cingulate gyrus and the decrease of ReHo in the temporal pole (all <0.05). (3) The correlative analysis showed that the changes in the ReHo values in the posterior cingulate gyrus, the thalamus and the precuneus were positively correlated to the changes of the gastric motility amplitudes. The changes in the ReHo values in the temporal pole was negatively correlated to the changes of the gastric motility amplitudes.</p><p><b>CONCLUSION</b>Acupuncture at the combined back- and front- points of the stomach, as well as acupuncture at single Weishu (BL 21) and Zhongwan (CV 12) induce the ReHo changes in the different brain regions. Acupuncture at the combined back- and front- points of the stomach may induce the ReHo changes in some new brain regions as compared with the acupuncture at the single point. The thalamus, the posterior cingulate gyrus and the precuneus may be the the important integrated brain regions for acupuncture at the back- and the front- points in regulating the gastric motility. The effects of acupuncture at the back- and the front- points for the regulation of the gastric motility are closely related to the thalamus, the limbic system and the default network of the brain regions.</p>
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Humans , Acupuncture Points , Acupuncture Therapy , Brain , Diagnostic Imaging , Physiology , Cross-Over Studies , Electroencephalography , Gastrointestinal Motility , Healthy Volunteers , Magnetic Resonance Imaging , StomachABSTRACT
Objective:To explore the significance of detecting serum CRP,myocardial enzymes,liver function index in pediatric patients with rotavirus infectious diarrhea.Methods:110 pediatric patients with rotavirus infectious diarrhea and 85 age-matched patients with bacterial infectious diarrhea who were both treated in our hospital from January,2014 to May,2016 were enrolled in the present study.Another 20 healthy patients who had physical examination in our hospital were considered as control group.The differences of serum CRP,IL-6,hs-cTnT,CK,CL-MB,AST,ALT level and the incidence of parenteral injury were compared.Results:The incidence rate of lower respiratory tract infectivity,rash,myocardial damage and hepatic injury in RV group were significantly lower than the bacterial infectious group (P＜0.05),the level of serum CRP,IL-6 in RV group and bacterial infectious group were significantly higher than the control group,and those of RV group were significantly lower than bacterial infectious group (P ＜0.05);the level of hs-cTnT,CK,CL-MB,AST,ALT in RV group were significantly higher than bacterial infectious group and control group (P＜0.05),and those indexes of bacterial infectious group were no significantly differences compared with healthy control (P ＞ 0.05).Conclusion:The combined detection of serum CRP,myocardial enzyme and liver function indexes were of certain significance in the early distinguishing diagnosis of bacterial infectious diarrhea from rotavirus infectious diarrhea.
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Objective To evaluate the risk clinic factors of severe community-acquired pneumonia in older adults,and to provide examples for its clinic application.Methods Sixty-four case patients who were admitted for a diagnosis of severe community-acquired pneumonia in older adults in Beijing Haidian Hospital from January 2013 to July 2015 were selected as observation group.One hundred cases patients also admitted for a diagnosis of community-acquired pneumonia were selected as control group.Within 24 h of admission,the clinical data were collected,medical history were collected,and the serum biochemistry,coagulation index fibrin degradation product,D-dimer and inflammatory factor procalcitonin were detected.The data were analyzed by univariate analysis,and logistic regression analysis was used to analyze the variables with significant difference in single factor analysis.Results Single factor analysis showed that the percentage of severe pneumonia with central nervous system disorders,severe pneumonia with aspiration,severe pneumonia with two or more comorbidities,aspiration and severe pneumonia with bedridden patient in observation group were obviously higher than the control group,the difference between two groups have remarkable statistical significance((82.21％ (53/64) vs.32％(32/100),60.93％(39/64) vs.1％(1/100),(84.37％,54/64) vs.54％(54/100),90.62％(58/ 64) vs.28％ (28/100),59.37％ (38/64) vs.11％ (11/100);P＜0.01 or P＜0.05).The mortality of observation group was higher than the control group,the difference between two groups have remarkable statistical significance(56.62％ (36/64)] vs.3％ (3/100),P=0.001).Albumin of severe pneumonia was obviously lower than the control group,the difference between two groups have remarkable statistical significance ((27.79 ±8.53) g/L vs.(33.66±9.63) g/L,P=0.011).Fibrin degradation product of severe pneumonia was obviously lower than the control group,the difference between two groups have remarkable statistical significance ((i0.98 ± ± 1.32) ng/L vs.(3.61±0.98) ng/L,P=0.002).D-dimer of severe pneumonia was obviously higher than the control group,the difference between two groups have remarkable statistical significance ((2.68± 0.56) mg/L vs.(0.42±0.12) mg/L,P=0.001).Procalcitonin of severe pneumonia was obviously higher than the control group,the difference between two groups have remarkable statistical significance ((1.63±0.32) ng/L vs.(0.13 ± ±0.21) ng/L,P =0.015).The result of multiple factors logistic regression analysis showed the aspiration,hypoproteinemia,D-dimer were severe community-acquired pneumonia in older adults's independent risks (OR =1.782,1.208,1.356,P＜0.05).Conclusion Aspiration,hypoproteinemia,D-dimer are the factors of risking suffering severe community-acquired pneumonia in older adults.D-dimer could be the detection index of severe community-acquired pneumonia in older adults.
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Objective: To determine the role of serum procalcitonin [PCT] and C-reactive protein [CRP] in predicting spontaneous bacterial peritonitis [SBP] in patients with advanced liver cirrhosis
Methods: A total of 88 patients with advanced liver cirrhosis were enrolled for this study, which included 40 cases with SBP and 48 cases with CNNA. Bacterial cultures, ascitic fluid [AF] leukocyte, C-reactive protein [CRP] and serum PCT measurements were carried out prior to the use of antibiotics. Receiver operating characteristic [ROC] curves were used to evaluate the diagnostic performance of procalcitonin levels
Results: Serum PCT levels in advanced liver cirrhotic patients with SBP were significantly higher than those with CNNA. We used PCT 0.78 ng/mL as optimal cutoff value to diagnose SBP, for which the sensitivity and specificity was 77.5% and 60.4%. The area under the curve [AUC] was 0.706 [95% confidence interval: 0.576-0.798]. The PCT level was significantly correlated with the AF WBC count [rs=0.404, P<0.01]. However, there was no significant difference between SBP and CNNA patients in serum CRP levels
Conclusion: According to our findings, serum PCT levels seem to provide an early diagnostic accuracy in advanced liver cirrhotic patients with SBP
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Objective]To investigate the effect of acupuncture-assisted anesthesia on cerebral state index(CSI) under the steady-state anesthesia of sevoflurane. [Methods] Fifty patients scheduled for elective knee arthroscopy operation were randomly divided into two groups with 25 in each. All patients were induced with sevoflurane, the end-tidal concentrations of sevoflurane in two groups were adjusted to 1.0 MAC and maintained for 15 min after tracheal intubation, acupuncture-assisted anesthesia was used on the affected side in group A, Yanglingquan(GB34) and Zusanli(ST36) were selected as the acupoints. The positive and negative electrodes of the electropuncture apparatus(G8650) were respectively connected with Yanglingquan(GB34) and Zusanli(ST36). People reccived transcutaneous electrical acupoint stimulation with condensation-rarefaction wave(2/15 Hz, 8~12mA) untill the end of operation, patiant's body types SBP, SDP, MAP, HR and CSI were recorded at lying still for 5 min(T1), steady state of sevoflurane(T2), acupuncture-assisted anesthesia after 20 and 30 min(T3, T4). [Results] SBP, DBP, MBP, HR and CSI at T3~T4 were significantly lower in group A than those in group B and T2(P<0.05). [Conclusion]Acupuncture-assisted anesthesia can reduce the CSI under the steady-state anesthesia of sevoflurane and lower blood pressure and heart rate at the same time.
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Objective To understand the relationship between the changes of coagulation function ,platelet parameters and retic‐ulocyte parameters with the Child‐Pugh grade in the patients with liver cirrhosis .Methods The coagulation function index (PT , APTT ,Fig ,TT) ,platelet parameters(PLT ,MPV ,PDW ,PCT) and reticulocyte parameters(RET# ,RET% ,IRF) were detected in 163 patients with liver cirrhosis and 50 healthy controls by using the automatic hematological analyzer and the automatic blood co‐agulation analyzer .Then the changes of coagulation function ,platelet parameters and reticulocyte parameters were compared be‐tween the liver cirrhotic group and the control groups ,and among different Child‐Pugh grade groups .Results Compared with the control group ,Fig in the liver cirrhosis group was declined ,PT ,APTT and TT were prolonged ,PLT and PCT was decreased ,while MPV and PDW were elevated ,RET count ,RET% and IRF were increased ,the difference between the two groups were statistically significant(P<0 .05);Fig was gradually declined with the Child‐Pugh grade elevation ,PT ,APTT and TT were prolonged ,PLT and PCT was decreased ,while MPV and PDW were increased with the Child‐Pugh grade elevation ,and RET count ,RET% and IRF were increased (P<0 .05) .Conclusion The blood coagulation disturbance and abnormality of platelet parameters and reticulocyte parameters exist in the patients with liver cirrhosis .The changes of coagulation function ,platelet parameters and reticulocyte param‐eters are closely related to the Child‐Pugh classificatione ,which are the important indicators for judging the liver damage ,bleeding tendency and bone marrow hematopoietic function in the patients with liver cirrhosis .
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The development of informatization and modernization of traditional Chinese medicine (TCM) has been restricted to some degree due to the lack of sufficient modern scientific evidence to support TCM theory. Rapid development of computer technology, information and imaging technology, which can be used to explore TCM theory and mechanism, may bring hope to solve this problem. In recent years, functional Magnetic Resonance Imaging (fMRI) has been widely used to study TCM theory and mechanism. However, shortage of interdisciplinary talents those who possess both medical and engineering knowledge has restricted the development of fMRI research in the field of Chinese medicine. With the development of the discipline of TCM information science in TCM colleges and universities, students majoring in TCM information science will be the main source of researchers engaging in TCM fMRI researches. The flourishing development of TCM fMRI researches will cultivate a large number of talents adapting in TCM information science who will promote the construction of TCM information science.
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Objective Objective To investigate the relationship between choroidopathy and integrated backscatter(IBS) of choroid in diabetes mellitus(DM) patients.Methods Eighty DM patients of 158 eyes were divided into 3 groups by the course of diabetic retinopathy(DR)-DM patients without DR group,DM patients with the background DR,DM patients with the proliferative DR.80 normal persons of 160 eyes were the control group.Their IBS values were measured on nose side,temple side and middle side of choroid by HP Sonos 5500,and the correction IBS values(IBS％) were calculated.Results With the deterioration of DR,the IBS and IBS％ of choroid increased.The statistical significance difference were found in various groups(P ＜ 0.01).Conclusions With the deterioration of diabetic choroidopathy,the IBS and IBS％ increased.The IBS technique is useful method to assess the diabetic choroidopathy.
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Objective:To assess coronary stenosis using 256-slice spiral CT (CTA).Methods:The data of 126 pa-tients diagnosed as coronary heart disease (CHD)using CTA and coronary angiography (CAG)Were retrospectively analyzed.The CAG results for CHD Were regarded as “gold standard”diagnosing CHD.The CTA diagnostic value for CHD and consistency of CAG and CTA diagnosing coronary stenosis Were analyzed.Results:A total of 393 cor-onary segments Were assessed using CTA.According to CAG results for CHD ,the CTA diagnostic accuracy Was 89.3%,sensitivity Was 91.4%,specificity Was 84.8%,negative predictive value Was 82.2% and positive predictive value Was 92.8%;the consistency of CAG and CTA diagnosing coronary stenosis Was good (Kappa value =0.755, P<0.01).Conclusion:The 256-slice spiral CT can diagnosing coronary stenosis,it possesses high sensitivity in di-agnosing vascular stenosis;as a simple and noninvasive examination it can be used as a reliable method for early screening subhealthy population and reexamine of putients With coronary heart disease.
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Objective To elevate the achievement rate of kidney biopsy puncture through the analysis of puncture angle choice of ultrasound guided automatic kidney biopsy in 518 patients. Methods Under the guidance of color Doppler ultrasound,using the 3.5MHz probe with probe holder,we performed kidney biopsy in the degrees of 40°(group X),45°(group Y),60°(group Z) and 70°(group P) with the horizontal plane. Resnlts The total achievement ratio is 100 %. The one time success rate in group Y and group Z is 100 % (group Y, 164/164 ; group Z, 186/186) ;group X is 4.8% (22/46) ;group P is 84.4% (103/122).Conclusion The automatic kidney biopsy an- gle under the guidance of ultrasound should be between 45° and 60° with the horizontal plane which is safe and has higher achievement ratio. In the meantime, complications can be avoided.
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Objective To establish chronic obstructive pulmonary disease(COPD)rat models,and to study the intervention of the formula of nourishing Qi,activating blood circulation and dispersing phlegm recipe on the morphology.Method To establish rat COPD models by intratracheal instillation of lipopolysaccharide and exposure to cigarette smoke.To instill intervention drug daily either the formula of nourishing Qi,activating blood circulation and dispersing phlegm recipe or the roxithromythin,starting on the 20th,30th and 40th day of the experiment respectively(the groups was named h 20,h 30,h 40,r 20, r 30 and r 40 for short),and to observe the effect on the morphology by means of collagen staining and image analyzer.Results The pathological changes and lung function in the model group were accorded with the human COPD.In drug intervention groups,airway inflammation and epithelial proliferation were alleviated to different degree compared to the model group.In model group,the collagen deposition was increased predominant type I collagen compared to the health comtrol group,and the deposition in the drug intervention groups were decreased compared to the model group,according to the Sirius redpolarizing microscopy morphometry method.The thickness of the airway wall in the model group was significantly increased compared to the health control group(P
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OBJECTIVE To study and analyze the risk factors of surgical incision infection. METHODS All of 17 044 aseptic surgery patients from 2004 to 2006 were investigated. RESULTS Totally 36(0.21%) cases occurred infection with class Ⅰ surgical site.The incision infection ratio was 0.24%,0.22% and 0.18% in 2004,2005,and 2006,respectively.The operation time more than three hours occurred in 17 patients,two and three hours were in 12 cases,and less than two hours in the seven cases,accounted for 47.23%,33.33% and 19.44%,respectively. CONCLUSIONS The risk factors of incision infection after aseptic were as age,operation times,seasons,perioperative administration and underlying diseases.In order suroery to prevent the incition infection in aseptic surgery,we should pay more attention to management and education among medical staff.