ABSTRACT
Objective To explore the curative effect of montelukast combined with budesonide in the treatment of cough variant asthma in children,to provide guidance for clinical practice.Methods From March 2015 to March 2017,90 children with cough variant asthma in the People's Hospital of Yanggu County were randomly divided into observation group(n =45) and control group(n =45) according to the digital table.The observation group was given budesonide combined with montelukast,while the control group was given budesonide combined with salbutamol sulfate.All patients were followed up for 3 months.The curative effect,cough relief time,cough disappearance time,incidence rate of adverse reaction and recurrence rate were compared between the two groups.Results The total effective rate of the observation group(95.56％) was significantly higher than 77.78％ of the control group(P ＜ 0.05).The cough relief time[(7.79 ± 3.23)d] and the cough disappearance time [(10.78 ± 2.36)d] in the observation group were significantly shorter than those in the control group [(9.16 ± 2.23) d,(12.24 ± 2.78) d] (all P ＜ 0.05).The incidence rate of adverse reactions of the observation group was 2.22％,which of the control group was 6.67％,there was no statistically significant difference between the two groups (P ＞ 0.05).The recurrence rate of the observation group (4.44％) was significantly lower than 17.78％ of the control group(P ＜ 0.05).Conclusion It is feasible to treat cough variant asthma in children with montelukast combined with budesonide,and it is helpful to reduce recurrence.
ABSTRACT
Objective To compare the effects of nicorandil and trimetazidine on endothelial function and inflammatory cytokines in patients with coronary heart disease after percutaneous coronary intervention (PCI),and to analyze the synergistic effect .Methods 160 patients with coronary heart disease underwent elective PCI were enrolled and randomly divided into four groups ,40cases in each group .The nicorandil group was given nicorandil tab-lets 5mg once time,3 times a day at 72h before PCI.The trimeshamazine group was given trimetazidine tablets 20mg once time,3 times a day.The combined group was given the same dose of nicorandil and trimetazidine .The control group was not given nicorandil or trimetazidine .The changes of CK -MB,cTnI,ET-1,NO,hs-CRP,TNF-αand IL-6 were observed and compared before and after PCI .Results The CK-MB and cTnI in the control group were significantly increased after PCI (t=2.500,3.663,all P<0.05;t=4.168,5.783,4.912,all P<0.05),but there were no statistically significant differences in the other three groups (all P>0.05).The level of cTnI in the control group was higher than that in the other three groups after PCI (F=11.960,15.643,16.078,all P<0.05).After PCI,the levels of ET-1,hs-CRP,TNF-αand IL-6 in the four groups were all significantly increased ( control group:t=6.897,5.293,all P<0.05;t=15.934,16.759,all P<0.05;t=8.516,9.209,all P<0.05;t=6.809, 6.757,all P<0.05;nicorandil group:t=2.254,P<0.05;t=8.903,11.280,all P<0.05;t=5.961,5.992,all P<0.05;t=4.235,4.738,all P<0.05;trimetazidine group:t=3.425,P<0.05;t=10.513,11.582,all P<0.05;t=4.117,5.696,all P<0.05;t =4.130,3.868,all P<0.05;combination group:t =3.180,P<0.05;t =9.204, 10.107,all P<0.05;t=4.839,6.214,all P<0.05;t=5.151,5.883,all P<0.05),and NO level was significantly decreased(control group:t=5.707,5.066,all P<0.05;nicorandil group:t=2.701,2.393,all P<0.05;trimetazi-dine group:t=3.662,3.163,all P<0.05;combination group:t=2.632,2.427,all P<0.05).The levels of ET-1, hs-CRP,TNF-αand IL-6 in the control group were significantly higher than those in the other three groups after PCI(F=9.709,7.794,P<0.05;F=43.772,47.321,P<0.05;F=15.252,10.565,P<0.05;F=5.632,4.372, P<0.05),and NO level in the control group was lower than that in the other three groups (F=14.138,8.374,all P<0.05).The level of NO in the nicorandil group was higher than that in the trimetazidine group (t=2.249,2.305, all P<0.05).There was no synergistic effect between nicorandil and trimetazidine in improving ET -1,NO,hs-CRP,TNF-αor IL-6(P>0.05).Conclusion Both nicorandil and trimetazidine may help to relieve PCI -related myocardial injury , improve endothelial function , inhibit inflammatory factors after PCI , but there is no synergistic effect.Nicorandil may be more effective in improving endothelial function .
ABSTRACT
Transposition of the great arteries(TGA) is one of the most common and severely congenital heart defects in the neonatal period,even though we have significantly improvement in prenatal diagnosis and postpartum treatment of TGA,patients with severely TGA still have no promising prognosis.Now,the exactly pathogenesis of TGA is still unknown,in the view of embryonic development,TGA is a kind of conotruncal anomalies,which highly associated with unbalanced development of left-right axis.Nodal signaling pathway is one of the most functional pathway in controlling the formation of left-right axis,so fully investigation of Nodal signaling pathway may help us to find deep pathogenesis of TGA.
ABSTRACT
BACKGROUND:Silicon carbide-carbon (C/C-SiC) composite materials are widely used, but no relevant experimental studies on medical prosthesis materials have been reported. OBJECTIVE: To demonstrate the feasibility of C/C-SiC composite materials as a substitute for facet joint prosthesis based on the biomechanical research and three-dimensional finite element analysis. METHODS:The predetermined size C/C-SiC composites and traditional carbon/carbon(C/C) composite materials were placed in an electronic universal testing machine, to measure and calculate material compressive elastic modulus, compressive strength, maximal anticompression force, flexural modulus, bending strength and maximal antibending force. Afterwards friction coefficient, wear volume and weight wear rate were measured. Using three-dimensional finite element analysis, finite element models of the third metacarpal bone were defined as C/C and C/C-SiC composite element types, respectively. 200 N axial force was applied to analyze the total displacement and node stress. RESULTS AND CONCLUSION:Compressive elastic modulus, compressive strength,maximal anticompression force, flexural modulus, bending strength and maximal antibending force of C/C-SiC composites were significantly higher than those of the C/C materials (P < 0.05); friction coefficient, wear volume, weight wear rate, total displacement as wel as node stress of C/C-SiC composites were significantly lower than those of C/C materials (P < 0.05). These results prove that C/C-SiC composite has favorable mechanical properties, antiwear ability, compression resistance and stress resistance.
ABSTRACT
Objective To observe the effect of surface electromyographic biofeedback on the pharyngeal phase activities in patients with dysphagia after stroke. Methods Seventy-six consecutive patients with pharyngeal dysphagia after stroke admitted to the departments of rehabilitation and neurology,brain hospital affiliated to nanjing medical university from August 2014 to February 2015 were enrolled retrospectively. After excluding 40 patients,the remaining 36 patients were divided into either a conventional training group (n =19)or a biofeedback group (n =17)by using the random number table. The patients of the conventional training group received swallowing function training only,while those of the biofeedback group also received the surface electromyographic biofeedback treatment on the basis of the therapy program of the conventional training group. The patients of both groups were treated 6 times a week for 4 weeks. The assessment of swallowing angiography,the digital measurement and analysis were performed before and after treatment. The outcome measures included the degree of openness of upper esophageal sphincter (UES),0pharyngeal transit time (PTT),and the maximum displacement of the hyoid bone (HmaxD). Results (1)The proportions of UES complete opening of the conventional training group before and after training were 26. 3% (5 / 19)and 47. 4% (9 / 19)respectively. There was significant difference between before and after training (χ2 = 5. 08, P =0.020). The proportions of UES complete opening of the biofeedback group before and after training were 47.1% (8/ 17)and 82.4% (14/ 17)respectively. There was significant difference between before training and after training (χ2 =11.46,P = 0. 001). There was no significant difference in the degrees of UES complete opening before training between the conventional training group and the biofeedback group (P >0. 05). There was significant difference in the degree of UES complete opening after training between the 2 groups (χ2 =4. 63,P = 0. 040). (2)PTT of the conventional training group before and after training was 0.24 ±0.07 and 0.19 ±0.06 s respectively. PTT of the biofeedback before and after training was 0.23 ±0.06 and 0. 15 ± 0. 05 s. There was significant difference between before training and after training (F = 154. 50,P = 0. 000). There was no significant difference in PTT before training between the conventional training group and the biofeedback group (P > 0. 05). There was significant difference in PTT after training between the 2 groups (F =4.66,P = 0. 038). (3)The HmaxD distances of the conventional training group before and after training were 0. 5 ± 0. 4 and 0. 9 ± 0. 4 cm respectively,the PTT of the biofeedback training before and after training was 0. 6 ± 0. 4 and 1. 3 ± 0. 6 cm respectively. There was significant difference between before training and after training (F = 137. 56,P = 0. 000). There was no significant difference in the HmaxD distance of the conventional training group and the biofeedback training group before training (P > 0. 05). There was significant difference in the HmaxD distance after training between the 2 groups (F = 4. 29,P = 0. 033). Conclusion The surface electromyographic biofeedback therapy in combination with the conventional swallowing training for the treatment of dysphagia after stroke has the synergistic efficacy.
ABSTRACT
Objective To explore the mechanism of Exenatide-induced rat pancreatic tissue lesion.Methods Thirty SD male rats were divided into three groups according to complete random design,and each group had 10 rats,namely Exenatide group,diabetes-model group and control group.Diabetes-model rats were induced by streptozotocin (STZ,35mg/kg) and high-sugar and high-fat diet.The Exenatide group and diabetes group were subcutaneously administered with Exenatide at a dose of 5 μg/kg twice a day.The control group was treated with same amount of saline.Ten weeks later,all the rats were sacrificed and the pancreatic tissues were harvested for routine pathological examination.Immunohistochemical method was used to detect the expression of α-smooth muscle actin (α-SMA) and type Ⅲ collagen protein in pancreatic tissue,and ELISA was applied to measure the expression of matrix metalloprotei-nase-2 (MMP-2) and MMP-9 in pancreatic tissue.Results In control group,there was no pathological change in pancreatic tissue.In Exenatide group,chronic inflammatory changes were observed; and the degree of inflammatory changes were much severe in diabetes group,and the pathological scores were gradually increased in the 3 groups (P ＜0.05).The expressions of MMP 2 in pancreatic tissue in control group,Exenatide group,diabetes group were (186.98 ± 23.24),(306.07 ± 59.82),(365.08 ± 89.55) μg/L,and the expressions of MMP-9 were (49.37 ± 7.08),(67.24 ±14.73),(87.37 ±13.39)μg/L.The values were significantly higher in Exenatide group and diabetes group than those in control group (P ＜ 0.05),but the difference between the two groups was not statistically significant.The numbers of α-SMA positive cells per high power field were (13.4 ± 5.97),(29.5 ± 8.80),(79.3 ± 27.23) in control group,Exenatide group,diabetes group,and the numbers of type Ⅲ collagen positive cells were (10.6 ± 4.93),(29.3 ± 12.95),(56.0 ± 27.21).The values were significantly higher in Exenatide group than those in control group,and the values were significantly higher in diabetes group than those in Exenatide group (P ＜ 0.05).Conclusions Long-term subcutaneous injection of Exenatide may activate pancreatic stellate cells and cause expression of α-SMA,Ⅲ collagen protein,and MMP-2,MMP-9,then induce chronic inflammatory changes.
ABSTRACT
Objective To study the detection value of serum fibronectin,electrolyte and myocardial enzyme in neonatal hypoxic-ischemic encephalopathy (HIE).Methods Ninety children with HIE were selected as the observation group,among them 28 cases of mild,34 cases of moderate,28 cases of serious,and 45 cases of normal full-term infant were selected as control group.The serum fibronectin,electrolyte and myocardial enzyme of two groups were detected.Results The serum fibronectin level in observation group was significantly lower than that in control group [(141.23 ± 45.21) g/L vs.(257.51 ± 28.99) g/L,P＜ 0.05].With clinical degree increased,the serum potassium level in observation group gradually increased,but the difference between control group and observation group,and among different clinical degree of observation group were not statistically significant (P ＞ 0.05).The serum sodium level gradually reduced,there were significant differences among mild,moderate,serious [(130.34 ± 3.22),(126.67 ± 3.54) and (122.45 ±2.80) mmol/L,respeetively,P ＜ 0.05],they were significantly lower than control group [(136.22 ± 6.21)mmol/L,P ＜ 0.05].The serum chlorine and calcium levels gradually reduced,mild were (98.99 ± 2.76) and (0.96 ±0.26) mmol/L,moderate were (97.21 ±3.41) and (0.95 ±0.28) mmol/L,and serious were (90.33 ± 3.09) and (0.71 ± 0.18) mmol/L,there was no significant difference between moderate and mild (P ＞ 0.05),serious were significantly lower than those in mild and moderate (P ＜ 0.05).The serum chlorine and calcium levels in mild,moderate and serious were significantly lower than those in control group [(103.43 ±3.21) and (1.42 ±0.01) mmol/L,P ＜0.05].With clinical degree increased,the aspartate aminotransferase,lactate dehydrogenase,creatine kinase,creatine kinase isozyme MB and hydroxyl butyrate dehydrogenase levels in observation group gradually increased,mild were (46.2 ± 12.3),(432.1 ± 145.2),(245.3 ± 104.2),(40.3 ± 7.9) and (374.1 ± 148.2) U/L,moderate were (84.4 ± 33.1),(569.3 ± 168.2),(845.1 ± 498.2),(112.1 ± 50.4) and (473.8 ± 139.2) U/L,serious were (122.1 ± 45.6),(966.9 ± 407.2),(1851.3 ± 912.3),(175.1 ±-55.6) and (834.1 ± 420.4) U/L,they were significantly higher than those in control group [(35.1 ±7.6),(261.9 ±47.1),(117.8 ±39.7),(11.4± 5.2) and (203.1 ±42.1) U/L](P＜0.05),and among different clinical degree of observation group were statistical significant (P ＜0.05).Conclusion The detection of serum fibronectin,electrolyte and myocardial enzyme in HIE children has important clinical practice significance,and can be used to evaluate the illness and prognosis.
ABSTRACT
ObjectiveTo investigate the effect and safety of salmeterol combined with fluticasone propionate dry powder in the treatment of cough variant asthma(CVA).Methods45 children diagnosed as CVA(aged from 5 to 14 years old)were randomly divided into treatment group(n =23)and control group(n =22).The patients in treatment group were treated with salmeterol combined with fluticasone propionate every morning and evening,while the control group were only given fluticasone propionate every morning and evening.The two groups were treated for 3 months.The change of clinical symptoms,asthma control time,lung function (PEF％ pred) and adverse reactions were observed before and after treatment.ResultsCough was relieved in most cases after treatment in both groups,but the improvement was more significant in treatment group than that in control group 1 week after treatment( x2 =10.24,P ＜ 0.05).However,there were no significant differences of clinical efficacy between two groups 2 weeks later( P ＞0.05).Full control time of asthma was in treatment group,which was significantly earlier than the control group( t =8.36,P ＜ 0.05 ).PEF％ pred was shorter significantly higher in two groups after 1 week,2 and 4 weeks,but the improvement was more significant in treatment group than that in control group( t =6.22,7.68,7.95,all P ＜ 0.05 ).1 case of headache in treatment group was relieved by symptomatic treatment and no other serious adverse events occured.ConclusionSalmeterol combined with fluticasone propionate was safe,effective,easy to use for treating CVA.