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ObjectiveTo collect and analyze the properties and application characteristics of external use of roots and rhizomes of Chinese herbal medicines in the Chinese Materia Medica（《中华本草》） to provide data references for the research on clinical external use of Chinese medicine， in order to provide data reference for clinical external use of traditional Chinese medicine（TCM）. MethodThe Chinese herbal medicines included in the Chinese Materia Medica were systematically screened. The inclusion criterion was the explicit mention of terms like "root", "rhizome", "root bark", "tuber", "tuberous root", etc. under the "Source" in the Chinese Materia Medica. Information on properties, flavors, meridian tropism, medicinal parts, fresh use, toxicity, efficacies and indications, and dosage of roots and rhizomes of Chinese herbal medicines was collected. The information was then entered into an Excel spreadsheet for statistical analysis. ResultThe Chinese Materia Medica records 2 662 roots and rhizomes of Chinese herbal medicines, of which 1 653 are suitable for external use. The predominant properties and flavors are cool, cold, bitter, pungent, and sweet. These Chinese herbal medicines mainly act on the liver, lung, and spleen meridians. The primary medicinal parts used include root, rhizome, and root bark. More than half of the roots and rhizomes of Chinese herbal medicines can be used in their fresh form. The main efficacies include clearing heat, removing toxins, resolving stasis, dispersing accumulation, resolving blood stasis and stopping bleeding, reducing swelling and alleviating pain, dispelling dampness and relieving pain. The main indications are skin sores, traumatic injuries, and rheumatic diseases. Common external application methods include poultice, decoction for washing, and applying powdered form. Most of these Chinese herbal medicines lack specific dosage guidelines for external use, with an emphasis on using an appropriate amount. ConclusionThe Chinese Materia Medica contains a wide range of roots and rhizomes of Chinese herbal medicines suitable for external use, with definite therapeutic effects, providing a broad perspective for the application of Chinese medicine externally. However, there are still problems such as unclear dosages and limited research. Further studies are necessary to better utilize the advantages of the external use of Chinese medicine.
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ObjectiveTo count and analyze the toxic traditional Chinese medicines and their characteristics in Chinese Materia Medica， so as to provide reference for the development and application of toxic drugs. MethodThe traditional Chinese medicines included in Chinese Materia Medica were screened one by one， and the inclusion criteria were "drug properties"， "usage and dosage" and "major poison， highly poisonous， poisonous， slightly poisonous， slightly poisonous" appearing in ancient books. Standard toxic traditional Chinese medicines were entered into an excel sheet for statistical analysis. ResultA total of 1 408 toxic Chinese medicines were included. The properties and flavors were mainly cold， bitter， pungent and sweet； the main meridians were liver， lung， spleen and stomach； the root， whole grass and leaves were the most used medicinal parts， and there were many toxic drugs. The pre-treatment methods are mainly sun-dried， fresh， fried， calcined， and sunburned； the efficacy categories are mainly heat-clearing drugs， rheumatism drugs， blood-activating and stasis-removing drugs； oral administration methods are mainly decoctions， pills， and powders ， mainly for external application， dipping， and coating； the dosage for oral administration is mostly 9-15 g， 3-9 g， 3-6 g， and an appropriate amount is mainly for external use. ConclusionThere are many toxic Chinese medicines clearly recorded in Chinese Materia Medica， but only 83 kinds of clearly toxic Chinese medicines are included in Chinese Pharmacopoeia， which need to be further strengthened by experimental observation and clinical data verification. The clinical application of toxic traditional Chinese medicine is mainly based on heat toxin blood syndrome and rheumatic arthralgia， which is closely related to its nature， taste and meridian return. Able to move， has the effect of activating Qi and activating blood， "sweet" can replenish energy and slow down， and has the effect of tonic， alleviation and pain relief， and mostly used for the treatment of heat syndrome， blood syndrome and arthralgia syndrome. However， there are certain limitations in the classification and processing conditions of toxic traditional Chinese medicines， which need to be further improved and scientifically verified.
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ObjectiveTo count and analyze the toxic traditional Chinese medicines and their characteristics in Chinese Materia Medica， so as to provide reference for the development and application of toxic drugs. MethodThe traditional Chinese medicines included in Chinese Materia Medica were screened one by one， and the inclusion criteria were "drug properties"， "usage and dosage" and "major poison， highly poisonous， poisonous， slightly poisonous， slightly poisonous" appearing in ancient books. Standard toxic traditional Chinese medicines were entered into an excel sheet for statistical analysis. ResultA total of 1 408 toxic Chinese medicines were included. The properties and flavors were mainly cold， bitter， pungent and sweet； the main meridians were liver， lung， spleen and stomach； the root， whole grass and leaves were the most used medicinal parts， and there were many toxic drugs. The pre-treatment methods are mainly sun-dried， fresh， fried， calcined， and sunburned； the efficacy categories are mainly heat-clearing drugs， rheumatism drugs， blood-activating and stasis-removing drugs； oral administration methods are mainly decoctions， pills， and powders ， mainly for external application， dipping， and coating； the dosage for oral administration is mostly 9-15 g， 3-9 g， 3-6 g， and an appropriate amount is mainly for external use. ConclusionThere are many toxic Chinese medicines clearly recorded in Chinese Materia Medica， but only 83 kinds of clearly toxic Chinese medicines are included in Chinese Pharmacopoeia， which need to be further strengthened by experimental observation and clinical data verification. The clinical application of toxic traditional Chinese medicine is mainly based on heat toxin blood syndrome and rheumatic arthralgia， which is closely related to its nature， taste and meridian return. Able to move， has the effect of activating Qi and activating blood， "sweet" can replenish energy and slow down， and has the effect of tonic， alleviation and pain relief， and mostly used for the treatment of heat syndrome， blood syndrome and arthralgia syndrome. However， there are certain limitations in the classification and processing conditions of toxic traditional Chinese medicines， which need to be further improved and scientifically verified.
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An imported case of acute schistosomiasis was reported in Wuhan City in 2020. The case was infected with Schistosoma by contact with the infested water due to playing water in the Yangtze River when working out of Hubei Province. The patient visited four medical institutions and the duration from onset to definitive diagnosis was 20 days. The patient’s low awareness of schistosomiasis prevention and control knowledge and lack of diagnosis and treatment awareness for schistosomiasis among medical institutions were considered as main causes of the development of acute schistosomiasis and progression to severe case. Intensifying schistosomiasis health education among mobile populations and improving the awareness and capability of early diagnosis of schistosomiasis among clinicians are recommended.
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Objective: To develop a powerful integrated strategy based on liquid chromatography coupled with mass spectrometry (LC-MS) systems for the comprehensive characterization and quantification of multiple components of herbal medicines. Methods: Firstly, different mobile phase additives, analysis time, and MS acquisition modes were orthogonally tested with liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (LC-QTOF/MS) in order to detect as many components of Gelsemium elegans as possible with high peak intensity. Secondly, several data mining strategies, including database searching, diagnostic ion filtering and neutral loss filtering, were utilized to perform chemical profiling. Subsequently, this study focused on the quantification and validation of the performance of a liquid chromatography-triple mass spectrometry (LC-QqQ/MS) assay based on derivative multiple reaction monitoring (DeMRM). Results: A total of 147 components from G. elegans were characterized, among them 116 nontarget components were reported for the first time. A sensitive and reproducible LC-QqQ/MS method was successfully developed and validated for the simultaneous relative quantification of 41 components of G. elegans. This LC-QqQ/MS method was then applied to compare the contents of components in the roots, stems and leaves. Conclusion: The present integrated strategy would significantly contribute to chemical studies on herbal medicine, and its utility could be extended to other research fields, such as metabolomics, quality control, and pharmacokinetics.
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OBJECTIVE@#To investigate the role of rebamipide in the treatment of acute gout arthritis rats induced by monosodium urate (MSU) crystal.@*METHODS@#Forty-two male rats were randomly divided into three groups (n=14). Group A was treated with oral rebamipide, group B with oral colchicine, and group C with oral placebo. The rats were monitored for the induction of arthritis with clinical manifestations and pathological changes, and the levels of interleukin (IL)-1β、IL-6、IL-10, and tumor necrosis factor (TNF)-α in serum were measured.@*RESULTS@#In group C, the clinical score and swelling index reached the maximum in 24 h, and then gradually decreased to 72 h. After 24 h of model induced, the clinical scores in group C were significantly higher than those in group A and group B [2 (1-3) vs. 0 (0-1) vs. 1 (0-2), P < 0.01], the swelling indexes in group C were significantly higher than those in group A and group B [0.36 (0.16-0.52) vs. 0.11 (0-0.20) vs. 0.12 (0-0.16), P < 0.01]. Histologically, after 24 h of model induced, there was a large number of neutrophil infiltration in the synovium of group C [scale score: 4 (2-4)], and there was no significant inflammatory cell infiltration in group A [1 (0-2)] and group B [1 (0-2)], the difference was statistically significant (P < 0.001). After 24 h of model induced, the levels of IL-1β, IL-6, IL-10, and TNF-α in serum of group C were significantly higher than those in group A and B [IL-1β: (41.86±5.72) vs. (27.35±7.47) vs. (27.76±5.28) ng/L, IL-6: (1 575.55±167.11) vs. (963.53±90.22) vs. (964.08±99.31) ng/L, IL-10: (37.96±3.76) vs. (21.68±4.83) vs. (16.20±2.49) ng/L, TNF-α: (21.32±1.34) vs. (15.82±2.54) vs. (17.35±7.47) μg/L, P < 0.001].@*CONCLUSION@#Rebamipide has a protective effect on acute gout arthritis rats induced by MUS crystals.
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Animals , Male , Rats , Alanine/analogs & derivatives , Arthritis, Gouty/drug therapy , Interleukin-1beta , Quinolones , Uric AcidABSTRACT
Objective:To explore the clinical efficacy of modified Guiling Ganluyin combined with colchicine in treatment of gouty arthritis(GA) damp-heat accumulation. Method:A total of 210 cases of GA were randomly divided into traditional Chinese medicine(TCM) group(70 cases), western medicine group (70 cases), and integrated traditional Chinese and western medicine group(70 cases) according to the digital table method. The patients in TCM group were treated with modified Guiling Ganluyin, the patients in western medicine group were treated with colchicine, and the patients in integrated traditional Chinese and western medicine group received modified Guiling Ganluyin + colchicine, with a treatment course of 30 d in all groups. The clinical symptoms before and after the treatment [joint pain visual analogue scale(VAS), patient global appraise(PGA), number rating scale for pain(NRS)], inflammatory cytokines in serum and joint fluid [tumor necrosis factor-alpha(TNF-α), interleukin-1β(IL-1β), uric acid(UA)], hemorheology index [whole blood high cut viscosity(HCV), whole blood low cut viscosity(LCV), whole blood reductive viscosity(RV)]in 3 groups were observed. The total effective rate and the adverse reactions were compared. Result:Six cases fell off during the study period. The total effective rate in integrated traditional Chinese and western medicine group was 97.1%（67/69）, which higher than 80.8%(55/68) in TCM group (χ2=8.153, P<0.05) and 79.1%(53/67) in western medicine group (χ2=8.735, P<0.05）. Compared with TCM group and western medicine group, the clinical symptoms VAS and NRS scores in integrated traditional Chinese and western medicine group were significantly lower(P<0.05), while the PGA scores were significantly higher(P<0.05). TNF-α, IL-1β and UA in serum and articular fluid in integrated traditional Chinese and western medicine group were significantly decreased(P<0.05). HCV, LCV and RV were significantly decreased in integrated traditional Chinese and western medicine group(P<0.05). Compared with the traditional Chinese and western medicine group, the incidence of adverse reactions was higher in the western medicine group (χ2=5.538,P<0.05) and lower in the Chinese medicine group (χ2=6.273，P<0.05). Conclusion:Modified Guiling Ganluyin combined with colchicine has the effects in enhancing effect and reducing toxicity, and could improve the clinical symptoms of GA patients with damp-heat accumulation, with a low incidence of adverse reactions.
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Based on the clinical characteristics of functional dyspepsia (FD), this paper analyzes and evaluates the consistency between the existing FD animal models and the clinical standards, so as to provide ideas and references for improving the FD animal model. By listing the clinical manifestations and diagnostic criteria of dyspepsia in traditional Chinese and western medicine, this paper assessed the existing animal models of functional dyspepsia, which conformed to 11.7% of the main symptoms and 5% of the secondary symptoms in clinical diagnosis criteria in western medicine, and 15% of the main symptoms and 5% of the secondary symptoms in traditional Chinese medicine（TCM）. The results showed that the high degree of anastomose was affected by "high fat feed + senna leaf decoction gavage + restraint + swimming". This method basically conformed with the clinical characteristics of FD in Chinese and western medicine. The deficiency lay in the large number of modeling factors and the lack of control, which might lead to FD model deviation. The average degree of conformity involved "gavage iodoacetamide combined with small platform station", "binding" and "tail clamping stimulation", and the low degree of conformity involved "gavage iodoacetamide" and "stomach implanted electrode". The above methods simulated the characteristics of FD, but the single factor lacked the manifestation of TCM symptoms, which needed further improvement. Therefore, multiple single factor modeling methods were combined, with focus on the development and use of TCM purgative as modeling drug, so as to control the modeling process. An attempt shall be made to develop a set of time schedule of various interference factors during the modeling period of animals, in order to constantly optimize the evaluation criteria of animal models, which is the future study direction of improving FD models.
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Objective::To observe the clinical efficacy of flavored Sanxitang combined with celecoxib in treating gonarthromeningitis caused by dampness and cold. Method::Totally 120 case were randomly divided into the control group and the treatment group, with 60 cases in each group. The control group was given celecoxib, and the treatment group was treated with flavored sanxitang combined with celecoxib for 30 d. The visual analogue scale (VAS), American knee association knee function scale (AKS), arthritis impact scale (AIMS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were observed before and after treatment. The circumferential diameter, articular cavity effusion and synovial hyperplasia thickness were measured. The serum tumor necrosis factor-α(TNF-α), matrix metalloproteinase (MMP)-3, serum interleukin-1 (IL-1) and erythrocyte sedimentation rate (ESR) were detected. The effective rate and adverse reactions were observed in two groups. Result::The total effective rate in treatment group was 94.8% (55/58), which was higher than 80.7% (46/57) in control group (P<0.05). Compared with before treatment, VAS, AIMS, WOMAC, knee circumference, articular cavity effusion and synovial hyperplasia thickness were significantly reduced in two groups (P<0.05), while the AKS score was significantly increased (P<0.05). Compared with after treatment, VAS, AIMS, WOMAC, knee circumference, articular cavity effusion and synovial hyperplasia thickness were significantly reduced in observation group (P<0.05), whereas the AKS score was significantly increased (P<0.05). TNF-α, MMP-3, IL-1 and ESR in two groups were significantly lower than those group before treatment (P<0.05). After treatment, TNF-α, MMP-3, IL-1 and ESR levels in observation group were significantly reduced compared with those in control group (P<0.05). The incidence rate of adverse reactions in treatment group was 5.89% (4/58), which was lower than 22.81% (13/57) in control group (P<0.05). Conclusion::Flavored Sanxitang combined with celecoxib could alleviate the clinical symptoms of gonarthromeningitis caused by dampness and cold, with a low incidence of adverse reactions.
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Objective:To investigate whether febuxostat with stepwise dose increase is as useful as colchicine prophylaxis in comparison with febuxostat with no dose titration when initial introduction of urate-lowering therapy in patients with gout. And to determine the effect of urate-lowering therapy in the treat to target by febuxostat with stepwise dose increase.Methods:In this prospective, multicentre, randomized open-label comparative study, patients were randomized to group A (stepwise dose increase of febuxostat from 10 to 40 mg/d), group B (fixed-dose febuxostat 40 mg/d plus colchicine 0.5 mg/d) or group C (fixed-dosefebu-xostat 40 mg/d) and were followed-up for 24 weeks. Non-steroidal anti-inflammatory drug was used to control symptoms when acute flare occurred. Patients were follow-up every 4 weeks. The comparison between groups was made by single factor analysis of variance (ANOVA). χ2 test was used to compare groups. Results:A total of 276 patients were randomized, and 253 patients were treated. 211 patients completed the study and were follow-up. Among the treated patients, gout flares were experienced by 12/84(25.0%) in group A, 20/85(23.5%) in group B and 26/42 (61.9%) in group C. There was no significant difference between group A and group B ( χ2=0.050, P=0.824) in gout flares. There was significantly higher frequency in gout flares in group C than that in group A and group B ( χ2=22.040, P<0.01). The proportion of patients reaching the target of urate-lowering therapy in group A at 4 and 8 weeks was significantly lower than that in group B and C. And there was no significant difference among the three groups after 12 weeks. Conclusion:Stepwise dose increase of febuxostat and low-dose colchicine has the same prophylaxis effectiveness in reducing gout flares but are more effective in prevent acute flare when compared with fixed-dose febuxostat alone. Stepwise dose increase of febuxostat may be an effective alternative to low-dose colchicine prophylaxis during the introduction of urate-lowering therapy.
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Objective: To explore the clinical efficacy and safety of modified Huqianwan in treatment of rheumatoid arthritis (RA) liver-kidney Yin deficiency syndrome, and investigate its possible mechanism. Method: A total of 184 patients with RA liver-kidney Yin deficiency syndrome were randomly divided into Chinese medicine group (62 cases), western medicine group (57 cases) and integrated Chinese and western medicine group (65 cases) according to the digital table method. The patients in Chinese medicine group were treated with Huqianwan; the patients in western medicine group were treated with methotrexate tablets and leflunomide tablets; and the patients in integrated Chinese and western medicine group received Huqianwan+methotrexate tablets and leflunomide tablets,with a treatment course of 12 weeks in all groups. The pain visual analog scale (VAS), swelling and tenderness scores of 28 joints (DAS28), average hands grip strength, morning stiffness time and liver-kidney Yin deficiency syndrome differentiation of traditional Chinese medicine (TCM) syndrome score were compared between groups before and after treatment. The changes of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), immunoglobulin (Ig) G, tumor necrosis factor-alpha (TNF-α) and rheumatoid factor (RF) were detected in all groups after treatment. Clinical efficacy, and incidence of adverse reactions such as gastrointestinal response, liver injury, leukopenia, serum glutamate oxaloacetic aminotransferase (GOT) and platelet (PLT) level changes were compared between the groups, so as to investigate the efficiency and safety of the different medicines. Result: After 12 weeks of treatment, the total clinical effective rate was 79.0%, 80.7%, and 92.3% respectively in Chinese medicine group, western medicine group, and integrated Chinese and western medicine group; the integrated Chinese and western medicine group was significantly better than the Chinese medicine group and western medicine group (PPPPConclusion: The efficacy in treating RA liver and kidney Yin deficiency syndrome shows no significant difference between modified Huqianwan and methotrexate tablets+leflunomide tablets. In the treatment of RA liver and kidney Yin deficiency syndrome, Huqianwan has fewer adverse reactions. Huqianwan combined with methotrexate tablets+leflunomide tablets is superior to that in methotrexate tablets+leflunomide tablets in treatment of RA liver-kidney Yin deficiency syndrome.
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Objective To analyze the endemic sitaution of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017, so as to provide the reference for further schistosomiasis control activities. Methods According to the data of the annual report on the prevention and control of schistosomiasis in Wuhan City in 2017, the spatial database regarding the endemic situation of schistosomiasis was established and analyzed by ArcMap 10.2. Results The 593 schistosomiasis-endemic villages in Wuhan City were mainly located in the Yangtze River and its major tributaries. Kernel density analysis showed that the endemic villages of three regions with the highest density was located in the west of Caidian District (Zhuru Street), the east of Hannan District (Shamao Street) and the southwest corner of Xinzhou District (Yangluo Street). The sero-positive population was densely distributed in the West of Caidian District (Zhuru Street), which accounted for 34.23% of all seruo-positives in the city. There were 492 farming cattle fenced in Donggan Village in Hongbei Street of Caidian District. A higher density of the area with Oncomelania hupensis snails was located in the southwest region of Caidian District (Xiaosi Street), accounting for 31.22% of the total area with snails. In 2017, the re-emerging area with snails was 36.60 hm2. The high kernel density region with snails was located in Zhuru Street of Caidian District. The region with high density of living snails was located in the central region of Hannan District (Hongbei Production Brigade), the average density of living snails was 0.36 snails/0.1 m2. Conclusions The endemic situation of schistosomiasis is at a low level in Wuhan City, and the spatial distribution is not uniform. In some local areas, the historical endemic situation of schistosomiasis is serious and the high risk factors are more concentrated. It is necessary to strengthen the surveillance of schistosomiasis.
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Objective To analyze the endemic sitaution of schistosomiasis based on geographic information system (GIS) in Wuhan City in 2017, so as to provide the reference for further schistosomiasis control activities. Methods According to the data of the annual report on the prevention and control of schistosomiasis in Wuhan City in 2017, the spatial database regarding the endemic situation of schistosomiasis was established and analyzed by ArcMap 10.2. Results The 593 schistosomiasis-endemic villages in Wuhan City were mainly located in the Yangtze River and its major tributaries. Kernel density analysis showed that the endemic villages of three regions with the highest density was located in the west of Caidian District (Zhuru Street), the east of Hannan District (Shamao Street) and the southwest corner of Xinzhou District (Yangluo Street). The sero-positive population was densely distributed in the West of Caidian District (Zhuru Street), which accounted for 34.23% of all seruo-positives in the city. There were 492 farming cattle fenced in Donggan Village in Hongbei Street of Caidian District. A higher density of the area with Oncomelania hupensis snails was located in the southwest region of Caidian District (Xiaosi Street), accounting for 31.22% of the total area with snails. In 2017, the re-emerging area with snails was 36.60 hm2. The high kernel density region with snails was located in Zhuru Street of Caidian District. The region with high density of living snails was located in the central region of Hannan District (Hongbei Production Brigade), the average density of living snails was 0.36 snails/0.1 m2. Conclusions The endemic situation of schistosomiasis is at a low level in Wuhan City, and the spatial distribution is not uniform. In some local areas, the historical endemic situation of schistosomiasis is serious and the high risk factors are more concentrated. It is necessary to strengthen the surveillance of schistosomiasis.
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To assess the schistosomiasis transmission risk after flood damage in Wuhan City.Schistosomiasis epidemic villages in Wuhan City were selected by using probability proportional to size sampling (PPS). The field investigations of Oncomelania hupensis snails, the activity of people and cattle on marshland, water infectivity of schistosome, reservoir host infection and wild feces contamination were conducted. I–III levels of risk environments were assessed and treated with appropriate measures.A total of 90 schistosomiasis epidemic villages and 170 environments were monitored. Totally 9 811 snails were dissected but no Schistosoma japonicum infected snails were found. There were significant decreases in the density of snails and the survival rate of living snails after the flood (χ2 = 102.517, t = 4.724, both P < 0.01). Totally 289 pieces of wild feces were captured, and no eggs of S. japonicum were detected. A total of 11 surveillance and forecast sites were detected on water systems, and 221 sentinel mice were placed. After breeding, 219 sentinel mice survived (99.10%), and no schistosome infection was detected. In addition, 1 720 mouse traps were placed in 3 survey sites, and 66 Apodemus agrarius were captured, and no schistosome-infected ones were found. All of the environments were assessed as Grade III. Meanwhile, 5 key schistosomiasis control areas were determined, and no emergency happened after the implementation of comprehensive control interventions.The risk of schistosomiasis transmission remains low in Wuhan City after the flood, but the potential epidemic risk cannot be ignored.
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<p><b>Background</b>Facing the increasing prevalence of gestational diabetes mellitus (GDM), this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes.</p><p><b>Methods</b>The data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected. Treatments during pregnancy and the last hospital admission before delivery were analyzed. Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age. The association between fasting plasma glucose (FPG) and adverse pregnancy outcomes was examined by logistic regression analyses.</p><p><b>Results</b>The average prevalence of GDM over the 5 years was 4.4% (1330/30,191). Within the GDM patients, 42.8% (426/996) received dietary intervention, whereas 19.1% (190/996) received insulin treatment. Adverse outcomes were more likely to occur in patients with unsatisfactory control of blood glucose such as respiratory distress syndrome (RDS, χ = 13.373, P < 0.01). Elevated FPG was identified as an independent risk factor for premature birth (odds ratio [OR] = 1.460, P < 0.001), neonatal care unit admission (OR = 1.284, P < 0.001), RDS (OR = 1.322, P = 0.001), and stillbirth (OR = 1.427, P < 0.001).</p><p><b>Conclusions</b>Management of GDM in the real world of clinical practice was unsatisfactory, which might have contributed to adverse pregnancy outcomes.</p>
Subject(s)
Female , Humans , Pregnancy , Blood Glucose , Diabetes, Gestational , Blood , Pregnancy Complications , Blood , Pregnancy Outcome , Retrospective Studies , Risk FactorsABSTRACT
<p><b>BACKGROUND</b>Liver cancer is a common cancer with poor prognosis in China. In this study, the national population-based cancer registration data were used to evaluate and analyze liver cancer incidence and mortality in China in 2011 and provide a reference for liver cancer prevention and control.</p><p><b>METHODS</b>We collected and evaluated the incidence and mortality data of liver cancer in 2011 from 177 cancer registries with qualified data. These data were used in the final analysis including calculating crude, standardized, and truncated incidences and mortalities, and estimated new liver cancer cases and deaths using age-specific rates and the corresponding populations. The national census in 2000 and Segi's population were used for age-standardized rates.</p><p><b>RESULTS</b>The estimates of new liver cancer cases and deaths were 355,595 and 322,416, respectively, in China in 2011. The crude incidence, age-standardized rate of incidence by Chinese standard population (ASRIC), and age-standardized rate of incidence by world standard population (ASRIW) of liver cancer were 26.39/100,000, 19.48/100,000, and 19.10/100,000, respectively; the crude mortality, age-standardized rate of mortality by Chinese standard population (ASRMC), and age-standardized rate of mortality by world standard population (ASRMW) of liver cancer were 23.93/100,000,17.48/100,000, and 17.17/100,000, respectively. The incidence and mortality were higher in rural areas than in urban areas and higher in males than in females. The age-specific incidence and mortality of liver cancer increased greatly with age, particularly after 30 years and peaked at 80-84 or 85+ years.</p><p><b>CONCLUSIONS</b>Liver cancer is a common cancer in China, particularly for males and residents in rural areas. Targeted prevention, early detection, and treatment programs should be carried out.</p>
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Female , Humans , Male , Age Factors , China , Databases, Factual , Incidence , Liver Neoplasms , Mortality , Registries , Rural Population , Sex Factors , Urban PopulationABSTRACT
<p><b>OBJECTIVE</b>To explore the current application and features of Aconite prescriptions with incompatible herbs in grade A class three hospitals in east China and central China through a clinical study and comparative analysis.</p><p><b>METHOD</b>Clinical prescriptions containing Aconite with incompatible herbs were collected. Association rules were utilized to analyze the compatible features of these herbs.</p><p><b>RESULT</b>This analysis found that the frequently used incompatible herba; pairs are Aconiti Lateralis Radix Praeparata-Pinelliae Rhizoma, with the support rate of 44.45%, occupying nearly half of the surveyed prescriptions; Pinelliae Rhizoma is the most frequently used herb in the two areas, with support rate up to 76.24%. Among the top 10 herbal pairs in the support rate, except for Aconiti Lateralis Radix Praeparata and Pinelliae Rhizoma, the top 10 herbs in Central China were mostly for warming the middle jiao and tonifying qi, such as Zingiberis Rhizoma, Atractylodis Macrocephalae Rhizoma and Codonopsis Radix; Whereas those in east China were mostly for activating and nourishing blood, such as Angelicae Sinensis Radix, Chuanxiong Rhizoma, and Salviae Miltiorrhizae Radix et Rhizoma. Among the top 10 herbal pairs in the support rate, except for Aconiti Lateralis Radix Praeparata-Pinelliae Rhizoma, the core herbal pairs applied in central China were mainly for resolving phlegm and warming the middle jiao, such as Pinelliae Rhizoma-Glycyrrhizae Radix et Rhizoma, Pinelliae Rhizoma-Zingiberis Rhizoma; Whereas those in east China were principally for activating blood and tonifying qi, like Atractylodis Macrocephalae Rhizoma and Pinelliae Rhizoma, Angelicae Sinensis Radix and Pinelliae Rhizoma. Among the core herbal groups in the two areas, the most frequently used herbal groups in the two areas are Aconiti Lateralis Radix Praeparata, Glycyrrhizae Radix et Rhizoma and Pinelliae Rhizoma with the support rate of 59.73%, accounting for the highest proportion among all of herbal groups.</p><p><b>CONCLUSION</b>There are the combined clinical application of Aconite with incompatible herbs, mostly with Aconiti Lateralis Radix Praeparata-Pinelliae Rhizoma, but with differences in the combined application in east China and central China.</p>
Subject(s)
Humans , Aconitum , Chemistry , Drug Incompatibility , Drug Prescriptions , Drugs, Chinese Herbal , Chemistry , Pharmacology , Pinellia , Chemistry , Sophora , ChemistryABSTRACT
Objective To study the pathophysiology of ankylosing spondylitis (AS)-related osteoporosis by investigating the relation between bone mineral density (BMD) and bone turnover markers.Methods Fortysix AS patients were included in this study,including 35 male and 11 female patients.Twenty-five gender and age matched healthy subjects were served as the healthy control group.Informed consents were obtained from all subjects.BMD of lumbar spine (L2-4),fermoral neck and radius were tested using dual-energy X-ray absorption method.Data about BASDAi,ESR,Ig was collected.Bone formation markers including procollagen type Ⅰ N-terminal peptide (PINP) and osteocalcin (OC) were included for analysis,the formal was measured by radioimmunoassay and the later was measured by immunoradiometric assay and bone resorption marker.β-Crosslaps was measured by electrochemiluminescence immunoassay.Independent-samples t test was used to compare normal distributed data between the two groups.Analysis of variance was used to compare the data between the three groups.For those data which were not normally distributed,Rank sum test was performed.Correlations were determined by Pearson or Spearman's ranking.Results ① 48％ of AS patients had bone loss,while the percentage in the healthy control group was 20％ (x2=5.32,P=0.021).BMD of lumbar spine,fermoral neck and radius of the AS patients were lower than the controls (t=-3.73,-3.68,-5.24; P＜0.05).② Bone density (BMD) of lumbar spine in patients at the late stage was higher than patients at early disease stage (t=2.26,P=0.034),however,the BMD in the femoral neck was not.③ The procollagen (PINP),OC and β-CrossLaps were not significantly different in patients at different stage of diseases (P＞0.05).④BMD of lumbar spine was negatively correlated with the β-CrossLaps and ESR(r=-0.325,P=0.047; r=-0.314,P=0.046),The BMD in fermoral neck was negatively correlated with β-CrossLaps and OC (r=-0.387,P=0.024; r=-0.371,P=0.034),but they were not correlated with disease duration and BADSAI.Conclusion Osteoporosis is common in AS.Bone turnover markers including bone formation and bone resorption are increased in AS.β-CrossLaps is likely to predict bone loss in AS.
ABSTRACT
Objective To investigate the operative indication,timing,method,selective standards of fetieided fetus and the number of reduced fetuses of selective multifetal pregnancy reduction in second trimester,and the pregnancy outcome of multifetal pregnancy by this operation.Methods Trans-abdominal selective multifetal pregnancy reductions in 37 cases of multiple pregnancy (twins 6 cases,triplets 21cases, quadruplets 8 cases,and quintuplets 2 cases) during 12~(+1) -25 weeks were performed under ultrasound guidance.The fetus to be reduced was injected potassium chloride (KC1) intraeardiacally until the fetal heartbeat stopped gradually.Totally 46 fetuses were reduced.Periodic prenatal examination and monitoring of coagulation function were carried out after the procedure.The pregnancy complications and pregnancy outcome of all cases were recorded.Results (1) The successful ratio of reduction was 100% (46/46 fetuses) and the successful pregnancy ratio was 88.9% (24/27).(2) Among all the 37 cases,fifteen deliveried after 36 weeks,seven deliveried in 32-36 weeks,three deliveried in 28-32 weeks,two aborted after feticide,and ten cases were in pregnancy at the time of this study.The mean gestational age of all was (34.9?4.1) weeks,and the delivery ratio after 28 weeks was 92.6% (25/27).(3) The mean birth weight of singletons was (3014?640) g,and of twins was (2557?573) g.The neonates of three triplets all died except for in one case two fetuses were alive.(4) Except in two cases after reducing one fetus of monoamniotie twins,another one died within 24 hours,the remaining fetuses were all alive.(5) Pre- eclampsia occurred in three cases.None of the cases had blood coagulation disturbances.Conclusion (1) Selective muhifetal pregnancy reduction in second trimester can feticide the abnormal fetus objectively or reduce the fetal number effectively.It is a safe procedure to decrease the complications of multifetal pregnancy and increase the birth weight.(2) ff the intention is reducing the fetal number,we choose the fetus who lies in the fundus uteri and reduce the muhifetal pregnancy to twins.(3) It is advised to aviod performing the procedure during vaginal bleeding.We reduce fetus after vaginal bleeding stops for one or more weeks.(4) Selective second-trimester multifetal pregnancy reduction will not result in the disturbance of blood coagulation and the death of remaining fetus.The incidence of pre-eclampsia is decreased after muhifetal pregnancy reduction.