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ObjectiveTo evaluate the clinical efficacy of modified Houpo Dahuangtang in moderate and severe acute respiratory distress syndrome （ARDS） patients with phlegm-heat accumulation，and monitor the pulmonary ventilation changes of patients before and after treatment by electrical impedance tomography（EIT）. MethodThe 62 cases of moderate and severe ARDS patients with phlegm-heat accumulation who required mechanical ventilation in the department of intensive care unit （ICU） in Chongqing Hospital of Traditional Chinese Medicine from September 2021 to June 2022 were selected，and divided into an experimental group（31 cases）and a control group（31 cases）using a random number table. On the basis of regular Western medicine treatment，the experimental group received modified Houpo Dahuangtang and the control group received warm water by a nasogastric tube for seven days. The changes in the clinical efficacy of traditional Chinese medicine（TCM），the oxygenation index［arterial oxygen partial pressure （PaO2）/fractional inspired oxygen（FiO2），P/F］，lactic acid（Lac），acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score，compliance，plateau pressure，gas distribution parameters monitored by EIT（Z1，Z2，Z3 and Z4），inflammatory factors［interleukin-6 （IL-6），IL-10， tumor necrosis factor-α （TNF-α） and C-reactive protein （CRP）］ of both groups before and after treatment were recorded. Besides， the mechanical ventilation time， length of stay in ICU， 28-day mortality and incidence of adverse reactions（delirium，abdominal pain and diarrhea）in the two groups were also observed. ResultThere was no significant difference in the baseline indexes of patients in the two groups，and thus the two groups were comparable. After treatment for one week， the total effective rate for TCM syndromes in the experimental group was 90.30%（28/31）， higher than the 67.74%（21/31）in the control group（Z=-2.415，P<0.05）.Compared with the same group before treatment， the plateau pressure and Lac decreased （P<0.01）and the compliance and P/F increased （P<0.01） in experimental group， while the Lac decreased （P<0.05）and the P/F increased （P<0.05）， and the compliance and plateau pressure did not change significantly in the control group. After treatment，the plateau pressure and inflammatory factors in the experimental group were lower than those in the control group（P<0.05）， but the compliance and P/F in the experimental group were higher than those in the control group（P<0.05）， and the gas distribution parameters Z1，Z2，Z3，Z4，Z1+Z2，and Z3+Z4 monitored by EIT in the experimental group were all higher than those in the control group （P<0.05）. There was no significant difference in mechanical ventilation time， ICU hospitalization time， 28-day mortality， delirium， abdominal pain， diarrhea and other adverse reactions between the two groups. ConclusionModified Houpo Dahuangtang can significantly improve the P/F，pulmonary ventilation in gravity-dependent regions and pulmonary compliance，reduce the release of inflammatory factors in moderate and severe ARDS patients. Compared with conventional methods，EIT can timely monitor the pulmonary ventilation changes in ARDS patients，which suggests its clinical feasibility.
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OBJECTIVE:To discuss the effects of cyclosporine combined with methylprednisolone sodium succinate pulse thera-py on pulmonary fibrosis in patients with acute paraquat poisoning. METHODS:By retrospective study method,39 cases of acute paraquat poisoning were divided into observation group(21 cases)and control group(18 cases)according to therapy plan. Control group received blocking the absorption of poison,promoting the discharge of poison’supportive and symptomatic treatment;obser-vation group was additionally given Methylprednisolone sodium succinate for injection 1 000 mg,ivgtt,qd+Cyclosporin injection 5 mg/kg,ivgtt,qd,pulse therapy;the dose of dethylprednisolone sodium succinate decreased gradually since forth day and it had been stopped after 7 days. The serum levels of hyaluronic acid(HA),laminin(LN),Ⅳ collagen(CⅣ),Ⅲ procollagen(PCⅢ), matrix metalloproteinase(MMP)9 and serum matrix metalloproteinase inhibitors(TIMP)1, lung HRCT score were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:HA and PCⅢ of observation group on 3rd and 5th day of treatment were significantly lower than those of control group,and HA,CⅣ and PCⅢ on 7th and 14th day of treatment were significantly lower than those of control group,levels of MMP-9 in observation group on 3rd,5th,7th day of treatment were significantly low-er than those of control group,with statistical significance (P<0.05). Levels of TIMP-1 and HRCT score in 2 groups increased gradually 2 weeks after treatment,and that of observation group was significantly lower than that of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Cyclosporin combined with methylprednisolone sodium succinate pulse therapy can significantly relieve pulmonary fibrosis in patients with acute paraquat poi-soning with good safety.
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OBJECTIVE:To observe the efficacy and safety of aspirin combined with Dieda huayu powder in the prevention of deep vain thrombus (DVT) after great saphenous varicose vein surgery. METHODS:280 patients with great saphenous vein sur-gery were randomlt divided into control group and observation group. control group was given Aspirin enteric-coated tablet 100 mg breakfast in the next day of surgery,once a day;observation group was additionally given Diedahuayu powder 2 g to fumigate feet and non-operation place on ill leg in the next day of surgery. 7 d was a treatment course. The incidence of prothrombin time(PT), activated partial thromboplastin time(APTT),fibrinogen(Fg),platelet count and the incidence of DVT and adverse reactions af-ter surgery before and after surgery in 2 groups were observed. RESULTS:The incidence of DVT in observation group was signifi-cantly lower than control group,the difference was statistically significant(P0.05). CONCLUSIONS:Aspirin combined with Dieda huayu powder can more effectively prevent the DVT after great saphenous varicose vein surgery than only as-pirin,inhibit coagulation,with similar safety.
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Objective To investigate the effect of ginkgolide B(BN52021) on the NF-?B expression in pulmonary tissue of mice with LPS-induced acute lung injury.Methods Fifty Kunming mice were divided into 2 groups at random: LPS group(L group) and BN52021 pretreated group(B group),and then each group was subsequently divided into 5 subgroups according to different time point(0,1,3,9 and 12 h).The mice from corresponding groups received an intraperitoneal injection of normal saline or 20 mg/kg BN52021 followed by an injection of 15 mg/kg LPS 5 min later.The mice were sacrificed in 0,1,3,9 and 12 h after LPS injection.The wet/dry ratio(W/D) was recorded for pulmonary function and the pathological changes of lung tissues stained by HE were examined by light microscopy.The expression of NF-?B p65 was detected by Western blotting,and the levels of tumor necrosis factor-?(TNF-?) and interleukin-10(IL-10) were determined by ELISA.Results The significant increase of W/D was found after LPS injection in L group,which indicated the existence of pulmonary edema;while the W/D in B group was lower(P