ABSTRACT
Abstract Balamuthia mandrillaris infection is a rare infectious disease around the world, with high rates of morbidity and mortality. Its early and correct diagnosis is a big challenge for us, and without it the delay in starting effective treatment can lead to the development of encephalitis. This is a report of a case of Balamuthia mandrillaris infection in a Chinese boy, with red plaques on the nasal dorsum as the first presentation, who finally developed into fatal encephalitis. The authors have reviewed the related literature and share the special skin features in order to favor the early diagnosis of the disease and increase the chances of survival.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the differences in the clinical therapeutic effects on mild and moderate carpal tunnel syndrome between the combined therapy of regular acupuncture and contralateral needling technique at distal acupoints and the regular acupuncture.</p><p><b>METHODS</b>Sixty patients of mild and moderate carpal tunnel syndrome were divided into an observation group and a control group according to random number table, 30 cases in each one. Laogong (PC 8), Daling (PC 7), Neiguan (PC 6), Yuji (LU 10) and Hegu (LI 4) were selected on the affected side in the two groups. In the observation group, the reducing needling technique with lifting and thrusting was applied at first to Taichong (LR 3) and Zhongfeng (LR 4) on the opposite side and afterwards those on the affected side were stimulated. In the control group, acupuncture was given at the acupoints on the affected side. The even-needling technique was used at the acupoints on the affected side in the patients of the two groups. Acupuncture was given once every day, 30 min each time. The treatment for 10 days was as one session. The therapeutic effects were evaluated after 3 sessions. The changes in median nerve electrophysiology, Levine's carpal tunnel syndrome questionnaire, the patient-rated wrist evaluation (PRWE) and the evaluation of therapeutic effects were observed before and after treatment in the two groups.</p><p><b>RESULTS</b>The total effective rate was 90.0% (27/30) in the observation group, better than 70.0% (21/30) in the control group (<0.05). After treatment, the nerve sensory conduction velocity and the amplitude of median nerve were all increased in the two groups, indicating the significant differences (all<0.05). The increase in the observation group was more apparent than that in the control group (all<0.05). The symptom severity score (SSS) and function status score (FSS) were all reduced apparently after treatment in the two groups (both<0.05). SSS and FSS in the observation group were lower apparently than those in the control group after treatment (both<0.05). PRWE score after treatment was reducedapparently as compared with that before treatment in the two groups (both<0.05). The result in the observation group was lower than that in the control group after treatment (<0.05).</p><p><b>CONCLUSIONS</b>The combined treatment of regular acupuncture technique and the contralateral needling technique at distal acupoints achieves the definite therapeutic effects on mild and moderate carpal tunnel syndrome, apparently superior to the regular needling technique.</p>
ABSTRACT
Objective To explore the reparation role of recombinant human bone morphogenetic protein-4 mature peptide (rhBMP-4m) on hematopoietic system injury induced by irradiation in mice.Methods Ninety BALB/c mice were randomly divided into normal control group,model group and rhBMP-4m treatment group,with 30 mice in each group.The mice in model group and rhBMP-4m treatment group were irradiated by 60Co γ-ray(7.5 Gy) for 200 s;while the mice in normal control group did not receive irradiation.After irradiation,the mice in model group were given physiological saline 1.0 mL by peritoneal injection per day for 6 days;the mice in rhBMP-4m treatment group were given rhBMP-4m 0.5 mg by peritoneal injection per day for 6 days.The peripheral white blood cell count and marrow mononuclear cells,the percent of CD34 + cells in marrow mononuclear cells of mice were detected on the first,third,fifth,seventh,ninth day after irradiation;the number of spleen nodus and the pleen weight/body weight ratio were detected at the ninth day after irradiation.Results There was no statistic difference in the number of peripheral white blood cells of mice among the three groups on the first day after irradiation(P ＞ 0.05).The peripheral white blood cell count of mice in model group was significantly lower than that in the normal control group on the third,fifth,seventh,ninth day after irradiation (P ＜ 0.01).There was no statistic difference in the number of peripheral white blood cells of mice between rhBMP-4m treatment group and model group on the third,fifth day after irradiation (P ＞ 0.05);the peripheral white blood cell count of mice in rhBMP-4m treatment group was significantly higher than that in model group on the seventh,ninth day after irradiation (P ＜ 0.05).The number of marrow mononuclear cells of mice in model group was significantly lower than that in the normal control group at each time piont after irradiation(P ＜ 0.05).There was no statistic difference in the number of marrow mononuclear cells of mice between the rhBMP-4m treatment group and model group on the first,third day after irradiation (P ＞ 0.05);the number of marrow mononuclear cells of mice in rhBMP-4m treatment group was significantly higher than that in the model group on the fifth,seventh,ninth day after irradiation(P ＜ 0.05).The proportion of CD34 + cells in mononuclear cells of mice in model group was significantly lower than that in the normal control group at each time piont after irradiation(P ＜0.01).There was no statistic difference in the proportion of CD34 + cells in mononuclear cells of mice between the rhBMP-4m treatment group and model group on the first,third day after irradiation (P ＞ 0.05);the proportion of CD34 + cells in mononuclear cells of mice in rhBMP-4m treatment group was significantly higher than that in the model group on the fifth,seventh,ninth day after irradiation(P ＜ 0.05).Compared with the normal control group,the number of spleen nodus was increased and the spleen weight/body weight ratio of mice was decreased in model group on the ninth day after irradiation(P ＜ 0.05);the number of spleen nodus and the spleen weight/body weight ratio of mice in rhBMP-4m treatment group were significantly higher than those in the model group on the ninth day after irradiation (P ＜ 0.01).Conclusion rhBMP-4m can accelerate the reconstruction of bone marrow hematopoietic system of mice with hematopoietic system injury induced by irradiation.
ABSTRACT
Objective To explore the relationship between gastric juice pH and hospital-acquired pneumonia ( HAP) , the gastric bacterial colonization and etiology of HAP in neurologic intensive care unit patients by monitoring gastric juice pH value.Methods From October 2014 to May 2015, consecutive seventy-two tube feeding patients admitted in the Department of Neurology Intensive Care Unit in Xijing Hospital were enrolled in this research.The type and concentration of pathogens from gastric contents were collected, while samples from upper respiratory tract and pharynx were detected dynamically at the same time.Results (1)The group with new onset HAP was higher in gastric juice pH (6.4(5.4,6.4) vs 5.4 (2.5, 6.4), Z=-2.37, P=0.01); (2) The isolation rate of colonized bacteria in gastric cavity was associated with the pH of gastric juice , achieving 60.8% ( 42/69 ) in HAP group; ( 3 ) When the gastric juice pH was >4, the isolation rate of Gram-negative bacilli in gastric cavity obviously increased (63.6%(28/44) vs 35.7%(10/28),χ2 =5.323, P=0.021); (4)The same pathogens were found in stomach-pharynx-upper respiratory tract in 7 cases ( 17.5%) of the total 40 HAP patients.Conclusion Increased gastric juice pH was associated with gastric colonization , especially Gram-negative bacilli , and may lead to a higher incidence of new onset HAP in patients on enteral feeding.
ABSTRACT
ObjectiveTo systematically evaluate the efficacy and safety of glycyrrhizin in patients with chronic severe hepatitis B. MethodsLiterature published from January 1990 to July 2014 were searched in databases including PubMed, Cochrane Library, CBMdisc, CNKI, VIP, and Wanfang Data. The randomized controlled trials comparing the efficacy of glycyrrhizin combined with internal comprehensive therapy versus internal comprehensive therapy alone in patients with chronic severe hepatitis B were included in the analysis. The methodological quality of included trials was independently assessed and the data were extracted. Meta-analysis was carried out with Review Manager Software 5.1, and the heterogeneity, sensitivity, and bias of the analysis were evaluated. ResultsSeven randomized controlled trials involving 298 patients in the test group and 294 in the control group were included in the analysis. The results of meta-analysis showed that glycyrrhizin combined with internal comprehensive therapy was remarkably more effective than internal comprehensive therapy alone, indicated by significantly reduced mortality rate ［relative risk(RR)=0.56, 95% confidenceinterval(CI):0.42~0.76, P＜0.01］, significantly decreased level of total bilirubin (TBil) ［mean difference(MD)=-92.56, 95%CI:-122.92~-62.20, P＜0.01］, and significantly higher prothrombin activity (PTA) ［mean difference(MD)=11.14, 95% CI:5.40~16.87, P＜0.01］. No severe adverse reactions were found in all patients. ConclusionGlycyrrhizin can significantly reduce the mortality and improve TBil and PTA in patients with chronic severe hepatitis B.
ABSTRACT
Objective To summarize the experience on treatment for 15 cases of acute pulmonary embolism(PE).Methods Fifteen acute PE patients admitted from June 2009 to May 2011 were analyzed retrospectively.All patients were diagnosed as PE and deep vein thrombosis,and treated with placement of inferior vena caval filters(IVC).Five patients with main pulmonary artery embolism accepted intrapulmonary arterial interventional therapy of thrombus fragmenlation and suction and catheter-directed thrombolysis (CDT).Ten patients with embolization on pulmonary artery branch and acute iliofemoral vein thrombus accepted therapy of peripheral thrombolysis.During postoperative course improvement was observed on the clinical symptoms,occurrence of complications,Miller index,change of mean pulmonary arterial pressure (mPAP) and arterial partial pressure of oxygen(PO2),as well as the patency of pulmonary artery.Result Five main pulmonary artery embolization patients gained complete patency of pulmonsnary artery,and the clinical symptoms immediately improved.Miller index reduced from (0.51 ± 0.04) to (0.27 ± 0.38),mPAP decreased from (55.3 ± 3.1 ) mm Hg to ( 32.7 ± 2.2 ) mm Hg,and PO2 elevated from ( 40 ±3 ) mm Hg to ( 63 ± 4) mm Hg,showing a significant difference ( P ＜ 0.01 ).Ten patients with pulmonary artery branch embolization gained patency of pulmonary artery branch,iliofemoral venous thrombosis cleared,and clinical symptoms significantly improved.All patients recovered after two weeks of intravenous thrombolytic,anticoagulation and antiplatelet therapy.During three to twelve months' follow up,the therapeutic effects persisted and there was no recurrence.Conclusions Emergency intrapulmonary arterial interventional therapy of acute PE has remarkable effectiveness,safety and feasibility,improving pulmonary obstruction and clinical symptoms.
ABSTRACT
Tumor angiogenesis is the uncontrolled growth of blood vessels in tumors,serving to supply nutrients and oxygen,and remove metabolic wastes.Kaposi's sarcoma (KS),a multifocal angioproliferative disorder characterized by spindle cell proliferation,neo-angiogenesis,inflammation,and edema,is associated with infection by Kaposi's sarcoma-associated herpesvirus (KSHV).Recent studies indicate that KSHV infection directly promotes angiogenesis and inflammation through an autocrine and paracrine mechanism by inducing pro-angiogenic and pro-inflammatory cytokines.Many of these cytokines are also expressed in KS lesions,implicating a direct role of KSI-IV in the pathogenesis of this malignancy.Several KSHV genes are involved in KSHV-induced angiogenesis.These studies have provided insights into the pathogenesis of KS,and identified potential therapeutic targets for this malignancy.
ABSTRACT
<p><b>OBJECTIVE</b>To probe into the clinical therapeutic effect of acupuncture on coronary heart disease complicated by type 2 diabetes mellitus (CDM) and the mechanism.</p><p><b>METHODS</b>Using multi-central, randomized, controlled and blind methods, 120 cases of CDM were divided into an observation group and a control group, 60 cases in each group. They were treated by routine therapy for diabetes mellitus, and in the observation group, acupuncture at Quchi (LI 11), Hegu (LI 4), Xuehai (SP 10), Zusanli (ST 36), Yinlingquan (SP 9), Fenglong (ST 40). Diji (SP 8), Sanyinjiao (SP 6), etc. were added with the needling method for regulating spleen-stomach; while in the control group, acupuncture was given at Weiwanxiashu (EX-B 3), Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23), Yanglingquan (GB 34), etc. The treatment was given twice a day in the two groups. Clinical therapeutic effects were assessed according to clinical symptoms and signs, frequency and lasting time of angina pectoris, quantity of taking Glycerol Trinitrate, blood sugar, blood lipids, urinary albumin excretion rate, urinary beta2-microglobulin, urinary monocyte chemotactic protein-1 (MCP-1), ECG, heart color Doppler, etc.</p><p><b>RESULTS</b>The needling method for regulating spleen-stomach not only could improve the symptoms and signs of the patient, but also could improve the degree of ST segment moving down and the function of left artrium relaxation, and had benign regulative effect on glycometabolism, lipids metabolism and urinary albumin level, with significant differences as compared with the control group (P < 0.05 or P < 0.01). The markedly effective rate for improvement of ECG was 50.00% in the observation group and 13.79% in the control group.</p><p><b>CONCLUSION</b>The needling method for regulating spleen-stomach can improve the damage of heart and blood vessels induced by abnormal sugar and lipids, decrease the level of urinary protein, inhibit MCP-1 excessive expression, relieve myocardial load and raise cardiac output in the patient of coronary heart disease complicated by type 2 diabetes mellitus.</p>