ABSTRACT
ObjectiveTo observe the clinical efficacy of the Modified Tongmai Anshen Formula （通脉安神方加减， MTAF） in the treatment of stable angina pectoris （SAP） with sleep disorders. MethodsA total of 148 patients suffering from SAP with sleep disorder were included and randomly divided into control group and treatment group， with 74 patients in each group. The control group received conventional western medicine， and the treatment group additionally received MTAF （1 dose per day）， both for 4 weeks. The changes in angina pectoris symptoms， traditional Chinese medicine （TCM） syndromes， sleep quality， quality of life， serological indicators including serum intercellular adhesion molecule-1 （ICAM-1） and vascular cell adhesion molecule-1 （VCAM-1）， brain-derived nerve growth factor （BDNF） and tyrosine kinase receptor B （TrkB） were compared between groups before and after treatment， and the safety was evaluated. ResultsIn the treatment group and the control group， the total effective rates of TCM syndromes（82.43% vs 52.70%）， angina pectoris （79.73% vs 64.86%） and sleep （89.19% vs 68.92%） showing significant difference （P＜0.001）. After treatment， the total TCM syndrome score， primary symptom score， secondary symptom score， and secondary symptoms sleeplessness， restlessness， tiredness and fatigue individual score， angina pectoris score， PSQI total score and each item score were all significantly reduced in both groups， while the SF-36 single item score significantly increased （P＜0.05）. The total TCM syndromes and primary symptom scores， secon-dary symptoms sleeplessness， restlessness， tiredness and fatigue individual score， angina pectoris score， time to fall asleep， sleep quality， hypnotic medication， sleep disturbance， daytime dysfunction score and PSQI total score were significantly lower in the treatment group than those in the control group after treatment （P＜0.05）， while the somatic pain， general health status， social functioning， emotional functioning， mental health， and health change were significantly higher in the treatment group （P＜0.05）. After treatment， ICAM-1 and VCAM-1 level significantly decreased （P＜0.05）， and BDNF and TrkB levels increased （P＜0.05） in the treatment group， while BDNF level significantly decreased in the control group （P＜0.05）. The TrkB level was significantly higher in the treatment group compared to the control group after treatment （P＜0.05）. A total of four adverse events occurred during the treatment， none of which were considered to be related to this study. ConclusionMTAF can significantly improve angina pectoris symptoms， TCM syndromes， sleep quality and quality of life in patients suffering from SAP with sleep disorders， the mechanism of which may be related to the protection of vascular endothelial function and central neurons.
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Objective To identify the 2- year recurrence- related factors in patients with myasthenia gravis (MG) after treatment of low-dose tacrolimus. Methods The clinical data of 100 MG patients treated with low- dose tacrolimus from February 2011 to February 2016 were retrospectively analyzed. All patients were followed up at least 2 years, and the risk factors affecting the recurrence of MG patients were analyzed. Results At the end of follow-up, there were 49 cases who had recurrence, and the recurrence rate was 44.5％ (49 / 110). Logistic regression analysis result showed that reducing dosage or withdrawal, MG crisis and diabetes mellitus were the independent risk factors for recurrence of MG patients (OR = 134.113, 8.850 and 6.652; P < 0.01 or <0.05). Conclusions The rate of recurrence with low- dose tacrolimus treatment in patients with MG during 2 years is higher. Reducing dosage or withdrawal should be avoided, especially in patients with a history of MG crisis. Patients with diabetics mellitus need to control blood glucose stability to avoid recurrence.
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Objective To research the clinical characteristics of cerebral infarction involving the anterior and posterior circulation in the same time. Methods Collected the clinical data of 11 patients with cerebral infarction involving the anterior and posterior circulation in the same time, who was confirmed by clinical and radiographic examination. Results In the majority of 11 patients, they had multiple risk factors in the same time. By Chinese Ischemic Stroke Subclassification (CISS) criteria, there were 3 patients with large-artery atherosclerotic brain infarction (aortic arch atherosclerosis and intracranial and extracranial large arteries atherosclerosis coexist), 3 patients with cardiogenic stroke, 3 patients with undetermined etiology (intracranial and extracranial large arteries atherosclerosis and cardiogenic stroke maybe coexist), 2 patients with other etiologies(1 patient with Moyamoya disease, 1 patient with polycythemia vera). There were multiple vascular stenosis in the 3 patients with large artery atherosclerosis, and the posterior communicating artery was open. Conclusions Cerebral infarction involving the anterior and posterior circulation in the same time is rare, cardiogenic stroke is more often, the relevant examinations should be perfect to definite the rare cause.
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@#Objective To explore the relationship of D-Dimer and high sensitive C-reactive protein in serum in acute cerebral infarction. Methods 64 patients with acute cerebral infarction were measured with the D-Dimer and Hs-CRP and compared with that of 50 healthy subjects as the controls. Their scores of National Institutes of Health Stroke Scale (NIHSS) were recorded and the correlation with the D-Dimer and Hs-CRP level was analyzed. Results Compared with those in controls, the levels of D-Dimer and Hs-CRP in patients with acute cerebral infarction were significantly higher (P<0.05), and those in patients with large infarction area were significantly higher than those in patients with small infarction area (P<0.01). The levels of D-Dimer and Hs-CRP uncorrelated with the scores of NIHSS.Conclusion The D-Dimer and Hs-CRP level is helpful to assess the acute cerebral infarction.
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Objective To evaluate the role of lumbosacral somatosensory evoked potential (LSSEP) examination in the diagnosis of lumbosacral disc herniation (LDH). Methods Somatosensory evoked potential (SEP) from posterior tibial nerve, L_4, L_5 and S_1 dermatomes SEP, and lumbosacral SEP was recorded in 54 patients with radiculopathy caused by LDH. Results The SEP from posterior tibial nerve was abnormal in 22 cases (40.74%). The SEP from L_5 and/or S_1 dermatome was abnormal in 47 cases (87.04%, P
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Objective To explore the change and its significance of blood concentrations of high sensitive C-reactive protein(hs-CRP) and D-Dimer in patients with acute cerebral infarction caused by internal carotid artery.Methods The blood levels of D-Dimer and hs-CRP in 69 patients with acute cerebral infarction were measured,and compared with the normal controls.The relationships between the levels of hs-CRP and D-Dimer and NIHSS or the areas of infarction were analyzed.Results Compared with those in normal control group,the blood levels of D-Dimer and hs-CRP in patients with acute cerebral infarction increased significantly(all P