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Zhishi Xiebai Guizhitang is a classical prescription for the treatment of chest impediment with the method of warming Yang. It is included in the Catalogue of Ancient Classical Prescriptions issued by the National Administration of Traditional Chinese Medicine （First Batch）， with the effect of activating Yang， dissipating mass， moving Qi and resolving phlegm. Its main symptoms include chest fullness and pain， or even chest pain radiating to the back， wheezing， coughing， shortness of breath， and Qi reversal from the hypochondrium. In modern traditional Chinese medicine， Zhishi Xiebai Guizhitang is clinically used in the treatment of cardiovascular system， digestive system， respiratory system and other diseases， among which coronary heart disease， unstable angina pectoris， myocardial infarction， sinus bradycardia and other cardiovascular diseases have particularly significant effects. This paper reviewed the pharmacological studies of Zhishi Xiebai Guizhitang in the past 10 years. The results showed that each single medicine and the whole prescription alleviated the above cardiovascular diseases to a certain extent， with the pharmacological effects of improving intravascular environment， myocardial ischemia， myocardial ischemia-reperfusion injury， and myocardial hypoxia， anti-inflammation， plaque stabilisation， etc.， and the pharmacological mechanism involved the regulation of relevant active substances in vivo as well as related signaling pathways and ion channels， mainly including thromboxane B2 （TXB2）， prostacyclin I2（PGI2） and phosphatidylinositol 3-kinases/protein kinase B/endothelial nitric oxide synthase （PI3K/Akt/eNOS） signaling pathways， and ATP-sensitive potassium channels. In addition， the relationship between the pharmacological effects of some single medicines and transient receptor potential ankyrin 1 （TRPA1） has been reported that TRPA1 is a key to understanding the mechanism of Zhishi Xiebai Guizhitang in treating cardiovascular diseases， which is worth of further study.
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Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.
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Objective To investigate the structure and hemodyanmics characteristics of internal jugular veins (IJV) in normal population . Methods A total of 126 individuals for stroke screening and IJV ultrasound examination from Oct 2017 to May 2018 in our hospital were enrolled .The the level of IJV influx into innominate vein ( J1) ,the level of superior thyroid vein influx into IJV ( J2) and the level of the segment equal to from the bifurcation of common carotid artery to out of skull ( J 3 ) of IJV were evaluated by ultrasound . The parameters included the maximum diameters of the three segments during the smooth respiration period ,cross section area (CSA) ,the maximum velocity (Vmax) ,mean flow volume (FVm) and the maximum pressure gradient ( PGmax) . The parameters of bilateral IJVs were compared . The effects of gender and age on these parameters were analyzed . Results The structures and hemodynamics parameters of left IJV were lower than those of right IJV ( all P < 0 .05) . There was no difference in the parameter left/right ratio between male and female( P >0 .05) . With aging ,the left/right ratio of Vmax and PGmax were decreased ,especially at J1 segment ( P < 0 .05 ) . Conclusions Color Doppler flow imaging can evaluate the IJV structures and hemodynamics by assessing the diameter ,CSA ,Vmax ,FVm and PGmax . Right IJV is the dominated outflow side in normal population . With aging ,the drainage of left IJV is decreased .
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Objective To investigate the feasibility and effectiveness of internal jugular vein (IJV) intervention therapy in patients with cerebral venous sinus thrombosis (CVST)with color Doppler ultrasound (CDU). Methods Twelve patients with CVST diagnosed by CDU and the 13 IJV lesions (localized luminal stenosis in 9 cases,venous long-segment slender in 2 cases,and right IJV localized luminal stenosis,and long-segment slender on the left in 1 case)confirmed by magnetic resonance venography (MRV)and/ or digital subtraction angiography (DSA)were enrolled retrospectively. CDU examinations were used at 1 week before and after IJV intervention therapy,6 months,1 year,and 2 years. The changes of the maximum diameter and the maximum velocity (V max )of the IJV were compared. The success rate and the long-term efficacy of the intervention therapy were analyzed. Results One week after treatment,the CDU examinations showed that the diameter of IJV stenosis in 13 IJV were increased significantly compared with those before procedure (4. 7 ± 2. 1 mm vs. 2. 3 ± 1. 3 mm;t = 5. 325,P < 0. 01). The velocity of blood flow of IJV was improved compared with before procedure (localized stenosis in 10 IJV[50 ± 15 cm/ s vs. 87 ± 24 cm/ s];t = 6. 285,P < 0. 01). Six of the 12 patients were followed up for a mean of 18 ± 7 months, two patients had restenosis after balloon dilatation. Conclusions For CVST patients with IJV lesions,the preliminary observation has indicated that IJV intervention therapy may improve the lesion lumen and hemodynamics. However,the intervention therapy,especially after balloon dilatation,the incidence of restenosis is higher. CDU can be used as an objective evaluation means for the long-term efficacy of IJV stenosis.
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Objective To investigate the changes of amplitude of low frequency fluctuation (ALFF) of the resting state fMRI in cognitively impaired Parkinson' s disease patients and discuss its underling neurophysiological mechanism.Methods Blood oxygen level-dependent low-frequency amplitude (ALFF) in resting-state functional magnetic resonance imaging were calculated in 16 healthy controls(HC) and 29 idiopathic Parkinson's disease patients (16 of which were patients with cognitive normal,PDCN and 13 with cognitive impairment,PDCI).The brain regions showing increased and decreased ALFF in patients were demonstrated by comparing normal subjects with 2-sample t-test with threshold of P＜ 0.05 and the analysis of the relationship between the different regions of the brain activity and cognitive function tests scores were also analyzed.Results Compared with PDCN,the PDCI patients showed decreased activity in the caudate nucleus (-3,9,12),occipital lobe (0,-78,-15) and medial temporal lobe (42,9,-27) and increased activity in the superior frontal gyrus (9,63,24).PDCI patients showed increased activity mainly in the precuneus and inferior parietal lobules compared with controls.Additionally,the regions with ALFF changes had significant correlations with the cognitive performance of patients as measured by Montreal cognitive test(Beijing Version) and neuropsychological tests (including memory,attention,visuospatial functions and executive function).Conclusion The results demonstrate that there is a specific pattern of intrinsic activity in PDCI providing insights into neurophysiological mechanisms of the Parkinson's disease dementia.