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Abstract Objectives: Depression is common after both lacunar stroke and non-lacunar stroke and might be associated with lesion locations as proven by some studies. This study aimed to identify whether lesion location was critical for depression after both lacunar and non-lacunar strokes. Methods: A cohort of ischemic stroke patients was assigned to either a lacunar stroke group or a non-lacunar stroke group after a brain MRI scan. Neurological deficits and treatment response was evaluated during hospitalization. The occurrence of depression was evaluated 3 months later. Logistic regressions were used to identify the independent risk factors for depression after lacunar and non-lacunar stroke respectively. Results: 83 of 246 patients with lacunar stroke and 71 of 185 patients with non-lacunar stroke developed depression. Infarctions in the frontal cortex, severe neurological deficits, and a high degree of handicap were identified as the independent risk factors for depression after non-lacunar stroke, while lesion location was not associated with depression after lacunar stroke. Conclusion: The main determinants for depression after lacunar and non-lacunar stroke were different. Lesion location was critical only for depression after non-lacunar stroke.
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Purpose To investigate the clinicopathological features of primary subcutaneous lymphomatoid granulomatosis (LYG). Methods A case of primary subcutaneous LYG was observed by analysis of the clinical, histological features, immunophenotype and molecular pathology with review of the related literature. Results The male patient, 78-year-old, inadvertently found a mass of right axillary for more than 10 days. The boundary of the mass was clear, it seemed to have a capsule, the cut surface was grayish yellow and grayish red, the texture was medium. A large amount of coagulative necrosis was observed in the center of the mass under microscope. The peripheral area showed a morphological change of panniculitis, accompanied by pleomorphic lymphoid infiltration, showed central and vascular destructive infiltration, pathological mitosis was occasionally observed. Immunophenotyping showed that atypical large lymphoid cells expressed CD45 RB, CD20, CD30, while CD3, CD15, CD56, TIA-1, Granzyme B, ALK, CD21, Langerin and CD1 a, S-100 and CK (AE1/AE3) were negative. The proliferation index of Ki-67 ranged from 50％ to 60％. EBER in situ hybridization showed that positive cells were> 20/HPF.Neither acid fast staining nor TB-DNA testing supported tuberculosis. Molecular pathology found clonal Ig K gene rearrangement, TCRB + TCRG gene rearrangement showed the absence of monoclonal proliferating T cell population. Conclusion The primary subcutaneous LYG is a rare tumor. which can be diagnosed by combination of morphology, immunophenotype and molecular pathology.
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OBJECTIVE@#To investigate the effect and safety of Guanxinning Tablet (, GXN) for the treatment of stable angina pectoris patients with Xin (Heart)-blood stagnation syndrome (XBSS).@*METHODS@#One hundred and sixty stable angina pectoris patients with XBSS were randomly assigned to receive GXN (80 cases) or placebo (80 cases, Guanxinning simulation tablets, mainly composed of lactose), 4 tablets (0.38 g/tablet), thrice daily for 12 weeks. After treatment, an exercise stress test (treadmill protocol), Chinese medicine (CM) syndrome score, electrocardiogram (ECG), and nitroglycerin withdrawal rate were evaluated and compared in the patients between the two groups. Meanwhile, adverse events (AEs) were evaluated during the whole clinical trial.@*RESULTS@#Compared with the control group, the time extension of exercise duration in the GXN group increased 29.28 ±17.67 s after treatment (P>0.05); moreover, the change of exercise duration in the GXN group increased 63.10 ±96.96 s in subgroup analysis (P<0.05). The effective rates of angina pectoris, CM syndrome and ECG as well as nitroglycerin withdrawal rate were 81.33%, 90.67%, 45.76%, and 70.73%, respectively in the GXN group, which were all significantly higher than those in the control group (40.58%, 75.36%, 26.92%, 28.21%, respectively, P<0.05).@*CONCLUSION@#GXN was a safe and effective treatment for stable angina pectoris patients with XBSS at a dose of 4 tablets, thrice daily.
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This study aimed to explore the effect of ropivacaine combined with sufentanil on maternal lactation and infant, which were used by different anesthesia method for painless childbirth. 284 cases of voluntary acceptance of painless childbirth pregnant were involved in this study and divided into control group and observation group. Ropivacaine combined with sufentanil epidural anesthesia [CEA] was used in the control group, and ropivacaine combined with sufentanil epidural block [CSEA] anesthesia was used in the observation group. Meanwhile, maternal colostrum time, postpartum lactation and neonatal Apgar score were analyzed. The colostrum time of the observation group was significantly shorter than that in the control group and the lactation quantity of 24h was significantly higher than that in the control group. There were significant differences between the control and the observation groups [P<0.05]. However, there was no significant difference in neonatal Apgar score [p>0.05]. Combined spinal epidural anesthesia of ropivacaine combined with sufentanil is more conducive to the early postpartum lactation compared with epidural anesthesia. And both of the two ways of anesthesia had no effect on the neonatal Apgar score
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This study chose 60 cases of cesarean section for patients with epidural anesthesia [EA] combined spinal epidural anesthesia [CSEA] surgery for clinical application research. Compared with EA, the CSEA could work well in subarachnoid anesthesia and epidural anesthesia. Although it was with less dosage, it had a faster and better effect, good muscle relaxant condition. It not only improved the quality of the surgery, but also reduced the burden of the anesthesiologist
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<p><b>OBJECTIVE</b>To explore the characteristics of integrative medicinal diagnosis and treatment on chronic heart failure (CHF) by retrospectively analyzing the clinical data of 134 patients.</p><p><b>METHODS</b>Data of CHF patients hospitalized in Department of Cardiology, Xiyuan Hospital from Jan. 2003 to Dec. 2004 were collected and their characteristics of TCM syndromes, condition of treatment (both Western and Chinese medicine), and fatality rate were investigated and analyzed using the data system of Chinese medicine clinical research for coronary heart disease.</p><p><b>RESULTS</b>In the 134 CHF patients, the commonly encountered basic diseases were mainly the coronary heart disease, diabetes mellitus and hypertension; the main TCM syndrome types were qi deficiency and blood-stasis type, phlegm-stasis inter mingling type, both qi-yin deficiency type, inner water-dampness stagnancy type and yang deficiency type; showing a certain regularity between syndrome type distribution and cardiac functional NYHA grading. The total fatality rate was 6.87%, which was positively correlated with the age of patients, existence of old myocardial infarction and impairing of heart function. The Chinese medicinal treatment applied was mainly the methods of supplementing qi, activating blood circulation, dissolving phlegm and nourishing yin, and the preparations used for intravenous perfusion were mainly injections of Shengmai, Salvia mitrorrhiza, Sanchi total saponin, and acanthopanax.</p><p><b>CONCLUSION</b>The syndromes in CHF patients of Xiyuan Hospital mainly covered qi deficiency, blood stasis, phlegm blocking, and yang deficiency, who were mostly treated with integrative medicinal treatment. However, its superiority needs the support from evidence-based medicine.</p>
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Humans , Chronic Disease , Drugs, Chinese Herbal , Therapeutic Uses , Heart Failure , Diagnosis , Drug Therapy , Integrative Medicine , Methods , Medicine, Chinese Traditional , Qi , Retrospective StudiesABSTRACT
OBJECTIVE: To investigate the characteristics of syndromes of phlegm and blood stasis in patients with coronary heart disease by multiple statistical methods of matching matrix, factor analysis and clustering analysis, and to provide some references for classification and normalization of diagnosis of syndromes of phlegm and blood stasis of coronary heart disease. METHODS: The correlations among 46 kinds of symptoms in syndrome of non-phlegm and non-blood stasis, syndrome of blood stasis, syndrome of phlegm and syndrome of phlegm-blood stasis blocking in 200 patients with coronary heart disease were analyzed by matching matrix, factor analysis and clustering analysis. RESULTS: The manifestations of tongue and pulse in syndromes of phlegm and blood stasis were significantly different from those in syndrome of non-phlegm and non-blood stasis. The pathogenesis of viscera in syndromes of phlegm and blood stasis lied in the heart and kidney, and the syndrome of deficiency of heart qi was the most common one while the syndrome of deficiency of kidney qi took the secondary place. The syndrome of phlegm was often accompanied by syndrome of deficiency of spleen qi. Only 15 ones of 46 clinical symptoms showed high frequency in concomitant appearance in syndrome of blood stasis, syndrome of phlegm and syndrome of phlegm-blood stasis blocking. Apart from having the common symptoms in syndrome of deficiency in origin, the syndrome of phlegm especially showed white and greasy fur and slippery pulse as well as distention and fullness of chest and abdominal distension; the syndrome of blood stasis showed purplish tongue and ecchymosis on tongue as well as fixed pain; and the syndrome of phlegm-blood stasis blocking showed the main symptoms of both syndrome of phlegm and syndrome of blood stasis. CONCLUSION: The statistical methods of matching matrix, factor analysis and clustering analysis are convenient, and can definitely indicate the clinical characteristics and syndrome differentiation of viscera of different syndromes of phlegm and blood stasis, which are beneficial to further research of diagnosis and differentiation of such syndromes of coronary heart disease.
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OBJECTIVE: To explore the relationship between polymorphism of apolipoprotein E (ApoE) exon 4 gene and different syndromes in patients with coronary heart disease (CHD). METHODS: Two hundred patients with CHD were divided into four groups according to syndrome differentiation, including syndrome of phlegm (PS), syndrome of blood stasis (BSS), syndrome of phlegm-blood stasis blocking (PBBS) and syndrome of non-phlegm and non-blood stasis (NPNBS). One hundred healthy volunteers were included in control group. Blood lipids were measured by routine examination. Total DNA of peripheral blood was extracted. ApoE genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. All data were analyzed by SAS software. RESULTS: (1)The occurrence rate of epsilon4 allele of ApoE in patients with CHD was 19.5%, significantly higher than 9.5% in the control group (P<0.05), and the E 3/4 genotype was especially more frequent (P<0.01). (2) The levels of total cholesterol (TC), total triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) in patients with epsilon4 were higher than those in patients without epsilon4 (P<0.01). (3) The frequencies of epsilon4 allele and E3/4 genotype in patients with PS were significantly higher than those in patients with BSS (P<0.05). CONCLUSION: ApoE epsilon4 allele, especially E3/4 genotype, is the risk factor of CHD. There is a relatively close relationship between patients with ApoE epsilon4 allele and PS. It may be one of the main susceptible genes in CHD patients with PS.
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Objective To further study the clinical efficacy and safety of salvianolate injection for the treatment of angina pectoris in coronary heart disease (CHD)with heart-blood stagnation syndrome. Methods A randomized imitative-blind mutli-center clinical trials with positive control and 3 parallel tests was carried out in 480 cases. The patients were divided into three groups: the control group received salviane injection 20 mL (n=120), the treatment group 1 (n=240) and treatment group 2 (n=120) received salvianolate injection in a dosage of 200 mg and 400mg respectively . After 14-daytreatment , the clinical efficacy and safety of salvianolate were observed. Results The total angina pectoris efficacy rates were 88.085 %in treatment group 1, 89.744 %in treatment group 2 and 67.257 %in control group (P